Clinic for Surgical Oncology, Medias Klinikum Burghausen, Krankenhausstrasse 3a, 84489 Burghausen, Germany.
Department of Tumor Biology, Medias Klinikum Burghausen, Krankenhausstrasse 3a, 84489 Burghausen, Germany.
Curr Oncol. 2022 Jul 11;29(7):4868-4878. doi: 10.3390/curroncol29070386.
Therapeutic options in metastatic esophageal cancer (EC) are limited with unsatisfactory results. We evaluated the efficacy of regional chemotherapy (RegCTx) approach in diffuse metastatic EC using arterial infusion (AI), upper abdominal perfusion (UAP) and isolated-thoracic perfusion (ITP) in 14 patients (N = 8 adenocarcinoma (AC) and N = 6 squamous cell carcinoma (SQCC)) after failure to first-line palliative treatment.
All patients had previously failed first-line palliative treatment attempt with systemic chemotherapy (sCTx). In total 51 RegCTx cycles (12 AI, 3 UAP and 36 ITP) were applied using cisplatin, Adriamycin and Mitomycin C. The outcome was evaluated using RECIST criteria with MediasStat 28.5.14 and SPSS-28.0.
No grade III or IV hematological complications occurred. The overall response rate was 41% partial response, 27% stable and 32% progressive disease. Median overall survival (OS) was 38 months (95%CI 10.1-65.9). The OS was better in SQCC with 51 months The RegCTx specific survival was 13 months (95%CI 2.9-23.1) in the entire cohort and 25 months in SQCC patients.
RegCTx is a valuable safe approach and superior to the current proposed therapeutic options in metastatic EC after failure to first-line therapy.
转移性食管癌（EC）的治疗选择有限，疗效不尽如人意。我们评估了动脉灌注（AI）、上腹部灌注（UAP）和孤立性胸腔灌注（ITP）区域化疗（RegCTx）方法在 14 例一线姑息治疗失败的弥漫转移性 EC 患者（N=8 例腺癌（AC）和 N=6 例鳞状细胞癌（SQCC））中的疗效。
所有患者均在首次一线姑息治疗尝试中（sCTx），即全身化疗失败。共应用顺铂、阿霉素和丝裂霉素 C 进行 51 个周期的 RegCTx（12 个 AI、3 个 UAP 和 36 个 ITP）。使用 MediasStat 28.5.14 和 SPSS-28.0 评估 RECIST 标准下的结果。
无 III 级或 IV 级血液学并发症。总体缓解率为 41%部分缓解，27%稳定，32%进展。中位总生存期（OS）为 38 个月（95%CI 10.1-65.9）。SQCC 患者 OS 更好，为 51 个月。整个队列的 RegCTx 特异性生存率为 13 个月（95%CI 2.9-23.1），SQCC 患者为 25 个月。
RegCTx 是一种有价值的安全方法，在转移性 EC 一线治疗失败后优于目前提出的治疗选择。
