Title:Efficacy and Safety of Concurrent Chemoradiotherapy Combined with
Nimotuzumab in Elderly Patients with Esophageal Squamous Cell Carcinoma:
A Prospective Real-world Pragmatic Study
Volume: 23
Issue: 8
Author(s): Nuo Yu, Guowei Cheng, Jiao Li, Jun Liang, Tao Zhang, Lei Deng, Wenyang Liu, Jianyang Wang, Yirui Zhai, Wenqing Wang, Zefen Xiao, Zongmei Zhou, Dongfu Chen, Qinfu Feng, Nan Bi and Xin Wang*
Affiliation:
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer
Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
Keywords:
ESCC, nimotuzumab, elderly patients, chemoradiotherapy, overall survival, progression-free survival.
Abstract:
Background: Concurrent or definitive chemoradiotherapy is the standard treatment of locally
advanced esophageal squamous cell carcinoma (ESCC). Elderly patients could not tolerate the
standard concurrent chemotherapy and were treated with radiotherapy because of weak physical status
and multiple comorbidities.
Objective: The efficacy and safety profile of concurrent (chemo) radiotherapy combined with
nimotuzumab in elderly patients with ESCC were investigated.
Methods: Eligible elderly (≥70 years) patients with locally advanced ESCC were enrolled in this prospective,
real-world pragmatic study and received concurrent chemoradiotherapy or radiotherapy
combined with nimotuzumab. The primary endpoint was overall survival (OS). Secondary endpoints
were objective response rate, disease control rate, progression-free survival (PFS), and adverse drug
reactions.
Results: Fifty-three elderly patients were enrolled. Thirty-two (60.4%) were treated with radiotherapy
combined with nimotuzumab (RT+N), and 21 (39.6%) with concurrent chemoradiotherapy combined
with nimotuzumab (CRT+N). The median age was 75.8 years. Fourteen (56.0%) patients achieved a
partial response, and 11 (44.0%) patients achieved stable disease at 3 months. The median follow-up
duration was 24.4 (95%CI, 21.6-26.7) months. Median OS (mOS) was 27.0 (95%CI, 14.8-48.4)
months. Median PFS (mPFS) was 22.6 (95%CI, 12.4-not reached) months. Higher mPFS (not reached
vs. 12.0 months; p=0.022) and mOS (48.4 vs. 15.3 months; p=0.009) were observed in the CRT+N
group compared with the RT+N group. Most adverse reactions were grade 1-2 (46, 86.8%).
Conclusions: Concurrent chemoradiotherapy or radiotherapy combined with nimotuzumab was safe
and well-tolerated in elderly patients with locally advanced ESCC. ESCC patients treated with
CRT+N could live longer.