Chen Yongshun, Wu Xiaoyuan, Hao Daxuan, Cheng Xinyu, Zhang Lei, Zhang Yougai, Ke Shaobo, Shi Wei, He Chunyu
Department of Clinical Oncology, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Radiation Oncology, Zhengzhou University Affiliated Cancer Hospital, Zhengzhou, China.
Oncotarget. 2018 Jan 3;10(40):4069-4078. doi: 10.18632/oncotarget.23861. eCollection 2019 Jun 18.
Neoadjuvant therapy improves long-term locoregional control and overall survival after surgical resection for esophageal cancer, and neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy (nCRT) are commonly used in clinical practice. Nimotuzumab is a humanized monoclonal antibody against epidermal growth factor receptor (EGFR), the efficacy of nimotuzumab added to nCRT for esophageal cancer is uncertain. We conducted this retrospective study in which combining neoadjuvant treatment of nimotuzumab with chemoradiotherapy (Nimo-nCRT) is compared with nCRT and nCT for patients with potentially resectable locally advanced esophageal squamous cell carcinoma. One hundred ninety-five patients received neoadjuvant therapy and 172 (88.2%) underwent esophagectomy. Surgical resection was performed in 94.4% after Nimo-nCRT, versus 92.5% after nCRT and 83.5% after nCT ( = 0.026). The R0 resection rate was 100% after Nimo-nCRT, 95.9% after nCRT and 92.6% after nCT ( = 0.030). Pathological complete response (pCR) was achieved in 41.2% after Nimo-nCRT, versus 32.4% after nCRT and 14.8% after nCT ( = 0.0001). Lymph-node metastases were observed in 29.4% in the Nimo-nCRT group, versus 21.6% in the nCRT group and 35.8% in the nCT group ( = 0.093). More patients in the Nimo-nCRT and nCRT group developed grade 3 esophagitis compared to those in the nCT group, = 0.008. There was no difference in surgical complications between the treatment groups. nCRT results in improved R0 resection, higher pCR rate, and a lower frequency of lymph node metastases compared to nCT, adding nimotuzumab to nCRT is safe and appears to facilitate complete resection and increase the pCR rate.
新辅助治疗可改善食管癌手术切除后的长期局部区域控制和总生存期，新辅助化疗（nCT）或新辅助放化疗（nCRT）在临床实践中常用。尼妥珠单抗是一种抗表皮生长因子受体（EGFR）的人源化单克隆抗体，将尼妥珠单抗加入nCRT用于食管癌的疗效尚不确定。我们进行了这项回顾性研究，比较了尼妥珠单抗联合放化疗（Nimo-nCRT）与nCRT和nCT用于潜在可切除的局部晚期食管鳞状细胞癌患者的情况。195例患者接受了新辅助治疗，172例（88.2%）接受了食管切除术。Nimo-nCRT后手术切除率为94.4%，nCRT后为92.5%，nCT后为83.5%（P = 0.026）。Nimo-nCRT后R0切除率为100%，nCRT后为95.9%，nCT后为92.6%（P = 0.030）。Nimo-nCRT后病理完全缓解（pCR）率为41.2%，nCRT后为32.4%，nCT后为14.8%（P = 0.0001）。Nimo-nCRT组淋巴结转移率为29.4%，nCRT组为21.6%，nCT组为35.8%（P = 0.093）。与nCT组相比，Nimo-nCRT组和nCRT组发生3级食管炎的患者更多，P = 0.008。各治疗组手术并发症无差异。与nCT相比，nCRT可提高R0切除率、pCR率并降低淋巴结转移频率，在nCRT中加入尼妥珠单抗是安全的，似乎有助于完全切除并提高pCR率。
