Hu Jing, Chen Zhe, Lv Jiaming, Zheng Zhen, Bei Yanping, Chen Xue, Zheng Lu, Song Wenjie, Xu Yunbao
Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, Ningbo, China.
Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, China.
Front Oncol. 2022 Jul 6;12:905422. doi: 10.3389/fonc.2022.905422. eCollection 2022.
To evaluate the safety and effectiveness of nimotuzumab in combination with chemoradiotherapy for locally advanced cervical esophageal squamous cell carcinoma.
Retrospective analysis was conducted from September 2012 to February 2017 among 50 locoregional-advanced cervical esophageal carcinoma (CEC) patients who received concurrent chemoradiotherapy (CRT) combined with or without nimotuzumab at Ningbo Medical Center Lihuili Hospital. Intensity-modulated radiotherapy (IMRT) was administrated on all patients. All patients were divided into two groups, of which 26 (Group A) received 200 mg (22 of 50) or 400 mg (4 of 50) of nimotuzumab per week with CRT and 24 (Group B) received definitive CRT.
The median follow-up time was 23 months. The median overall survival (OS) and progression-free survival (PFS) were 40.6 and 21.1 months for all, respectively. The 1-, 2-, and 3-year OS rates on the whole were 79.6%, 62.1%, and 47.8%. There was no statistical difference in overall response rate and disease control rate between the two groups. Patients treated with nimotuzumab (group A) had better PFS than the definitive CRT group (group B) ( < 0.05). However, the median OS was 41.4 months in group A and 32.4 months in group B, respectively ( = 0.517). Multivariate analysis showed that PFS among those with lower Eastern Cooperative Oncology Group (ECOG) score (HR = 5.11; < 0.01), stage II (HR = 9.52; < 0.01) and the application of nimotuzumab combined with CRT (HR = 0.16; < 0.01) was much longer. Furthermore, ECOG, stage, C-reactive protein (CRP) baseline, and histological grade can also be used as independent predictors of OS. Grade >3 adverse reactions were not observed. The most common adverse event related to nimotuzumab was mild fever and the occurrence rate was 19% (5 of 26). The incidence of anemia was 65.4% in group A and 87.5% in group B ( < 0.05).
For locoregional-advanced CEC, nimotuzumab combined with IMRT and concomitant chemotherapy was tolerated and effective. In addition, patients with a normal pretherapeutic serum CRP level (CRP < 10 mg/L) can achieve better OS.
评估尼妥珠单抗联合放化疗治疗局部晚期颈段食管鳞状细胞癌的安全性和有效性。
回顾性分析2012年9月至2017年2月在宁波市医疗中心李惠利医院接受同步放化疗（CRT）联合或不联合尼妥珠单抗治疗的50例局部区域晚期颈段食管癌（CEC）患者。所有患者均接受调强放疗（IMRT）。将所有患者分为两组，其中26例（A组）在CRT的基础上每周接受200mg（50例中的22例）或400mg（50例中的4例）尼妥珠单抗治疗，24例（B组）接受单纯根治性CRT。
中位随访时间为23个月。所有患者的中位总生存期（OS）和无进展生存期（PFS）分别为40.6个月和21.1个月。总体1年、2年和3年OS率分别为79.6%、62.1%和47.8%。两组的总缓解率和疾病控制率无统计学差异。接受尼妥珠单抗治疗的患者（A组）的PFS优于单纯根治性CRT组（B组）（<0.05）。然而，A组的中位OS为41.4个月，B组为32.4个月（=0.517）。多因素分析显示，东部肿瘤协作组（ECOG）评分较低（HR=5.11；<0.01）、II期（HR=9.52；<0.01）以及应用尼妥珠单抗联合CRT（HR=0.16；<0.01）的患者的PFS更长。此外，ECOG、分期、C反应蛋白（CRP）基线和组织学分级也可作为OS的独立预测因素。未观察到3级以上不良反应。与尼妥珠单抗相关的最常见不良事件是轻度发热，发生率为19%（26例中的5例）。A组贫血发生率为65.4%，B组为87.5%（<0.05）。
对于局部区域晚期CEC，尼妥珠单抗联合IMRT及同步化疗耐受性良好且有效。此外，治疗前血清CRP水平正常（CRP<10mg/L）的患者可获得更好的OS。
