Objective:To investigate the safety and efficacy of nimotuzumab combined with radiotherapy for elderly patients with non-resectable esophageal carcinoma(EC).Methods:Eligible patients were aged 70 years or older and ha...Objective:To investigate the safety and efficacy of nimotuzumab combined with radiotherapy for elderly patients with non-resectable esophageal carcinoma(EC).Methods:Eligible patients were aged 70 years or older and had treatment-naive,histologically proven inoperable locally advanced EC.Enrolled patients received radiotherapy with a total dose of 50-60 Gy in 25-30 fractions,concurrent with weekly infusion of nimotuzumab.The primary end point was the rate of more than grade 3 toxicities.Results:From June 2011 to July 2016,46 patients with stageⅡ-IV EC with a median age of 76.5 years were enrolled.There were 10,28 and 8 patients with stageⅡ,III and IV disease,respectively.The common acute toxicities included esophagitis(grade 1-2,75.4%;grade 3,8.7%),pneumonitis(grade 1,4.3%;grade 2,6.5%;grade3,2.2%),leukopenia(grade 1-2,60.9%;grade 3-4,4.4%),gastrointestinal reaction(grade 1-2,17.3%;grade 3,2.2%),thrombocytopenia(grade 1-2,21.7%;grade 3,2.2%),and radiothermitis(grade 1-2,39.2%).The incidence of grade 3-4 adverse effects was 17.4%.No grade 5 toxicities were observed.Clinical complete response,partial response,stable disease,and progressive disease were observed in 1(2.2%),31(67.4%),12(26.1%),and 2(4.3%)patients,respectively.The median overall survival(OS)and progression-free survival(PFS)were 17 and 10 months,respectively.The 2-,3-,and 5-year OS and PFS rates were 30.4%,21.7%,19.6%,and 26.1%,19.6%,19.6%,respectively.Conclusions:Nimotuzumab combined with radiotherapy is a safe and effective therapy for elderly patients who are not surgical candidates.Further studies are warranted to confirm its therapeutic effects in elderly EC patients.展开更多
Background Pulmonary complications are a major cause of mortality after operation for cancer of the gastric cardia or esophagus.Although the risk involved in gastric cardiectomy or esophagectomy associated with a conc...Background Pulmonary complications are a major cause of mortality after operation for cancer of the gastric cardia or esophagus.Although the risk involved in gastric cardiectomy or esophagectomy associated with a concurrent major pulmonary operation is expected to be much higher,it has seldom been evaluated on the basis of clinical experience.The aim of this study was to investigate the possibility and feasibility of the gastric cardiectomy or esophagectomy associated with a major pulmonary operation.Methods From August 2003 to January 2011,14 patients underwent concurrent gastric cardiectomy or esophagectomy and a major pulmonary operation in our hospital.This included eight for pulmonary invasion of esophageal carcinoma,and six for synchronous lung tumor.All patients underwent systematic lymph node dissection for cardiac or esophageal cancer.To prevent postoperative complications,the operative approach and dissection procedures for cardiac or esophageal carcinoma were modified according to the associated pulmonary operation and the extent of cancer invasion.All thoracotomies for cardiectomy or esophagectomy were performed on the same side as the major pulmonary operation.Results All patients underwent a curative operation.There were no deaths or postoperative complications in the six synchronous lung tumor patients.In the eight pulmonary invasion patients,one patient died of respiratory failure 11 days after operation,and postoperative complications developed in four of them,but none was fatal.Six patients were still alive.Conclusions Curative gastric cardiectomy or esophagectomy associated with concurrent major pulmonary operation is not contraindicated in patients in good condition.In selected patients,when the operative procedures for cardiectomy or esophagectomy are appropriately modified to minimize the effect of the associated pulmonary operation,the treatment is associated with a low operative morbidity and mortality with an acceptable long-term survival.展开更多
目的探讨食管癌患者胸、腹腔淋巴结的转移规律及其对生存预后的影响。方法选取经微创食管癌切除术(minimally invasive esophagectomy,MIE)治疗的食管鳞癌患者103例,按照日本食管肿瘤研究会(Japan Esophageal Cancer Research Associati...目的探讨食管癌患者胸、腹腔淋巴结的转移规律及其对生存预后的影响。方法选取经微创食管癌切除术(minimally invasive esophagectomy,MIE)治疗的食管鳞癌患者103例,按照日本食管肿瘤研究会(Japan Esophageal Cancer Research Association,JEOG)淋巴结分区的标准进行淋巴结清扫,统计淋巴结的转移情况,分析淋巴结转移情况对3年总生存率的影响。结果胸上段食管癌主要向左、右喉返神经旁淋巴结转移。胸中段食管癌呈现双向淋巴结转移。胸下段食管癌主要向胃左动脉旁和肝总动脉旁淋巴结转移。食管癌患者3年总生存率在病变长度、分化程度、浸润深度、肿瘤位置和淋巴结转移方面比较,差异均具有统计学意义(均P<0.05)。结论淋巴结转移是影响胸段食管癌患者术后效果的重要影响因素,结合病变位置情况,重点清扫相应部位的淋巴结,并可依据病变长度、分化程度、浸润深度、肿瘤位置及淋巴结转移判定远期预后。展开更多
基金supported by Wu Jieping Medical Foundation,the National Key Projects of Research and Development of China(No.2016YFC0904600)。
文摘Objective:To investigate the safety and efficacy of nimotuzumab combined with radiotherapy for elderly patients with non-resectable esophageal carcinoma(EC).Methods:Eligible patients were aged 70 years or older and had treatment-naive,histologically proven inoperable locally advanced EC.Enrolled patients received radiotherapy with a total dose of 50-60 Gy in 25-30 fractions,concurrent with weekly infusion of nimotuzumab.The primary end point was the rate of more than grade 3 toxicities.Results:From June 2011 to July 2016,46 patients with stageⅡ-IV EC with a median age of 76.5 years were enrolled.There were 10,28 and 8 patients with stageⅡ,III and IV disease,respectively.The common acute toxicities included esophagitis(grade 1-2,75.4%;grade 3,8.7%),pneumonitis(grade 1,4.3%;grade 2,6.5%;grade3,2.2%),leukopenia(grade 1-2,60.9%;grade 3-4,4.4%),gastrointestinal reaction(grade 1-2,17.3%;grade 3,2.2%),thrombocytopenia(grade 1-2,21.7%;grade 3,2.2%),and radiothermitis(grade 1-2,39.2%).The incidence of grade 3-4 adverse effects was 17.4%.No grade 5 toxicities were observed.Clinical complete response,partial response,stable disease,and progressive disease were observed in 1(2.2%),31(67.4%),12(26.1%),and 2(4.3%)patients,respectively.The median overall survival(OS)and progression-free survival(PFS)were 17 and 10 months,respectively.The 2-,3-,and 5-year OS and PFS rates were 30.4%,21.7%,19.6%,and 26.1%,19.6%,19.6%,respectively.Conclusions:Nimotuzumab combined with radiotherapy is a safe and effective therapy for elderly patients who are not surgical candidates.Further studies are warranted to confirm its therapeutic effects in elderly EC patients.
文摘Background Pulmonary complications are a major cause of mortality after operation for cancer of the gastric cardia or esophagus.Although the risk involved in gastric cardiectomy or esophagectomy associated with a concurrent major pulmonary operation is expected to be much higher,it has seldom been evaluated on the basis of clinical experience.The aim of this study was to investigate the possibility and feasibility of the gastric cardiectomy or esophagectomy associated with a major pulmonary operation.Methods From August 2003 to January 2011,14 patients underwent concurrent gastric cardiectomy or esophagectomy and a major pulmonary operation in our hospital.This included eight for pulmonary invasion of esophageal carcinoma,and six for synchronous lung tumor.All patients underwent systematic lymph node dissection for cardiac or esophageal cancer.To prevent postoperative complications,the operative approach and dissection procedures for cardiac or esophageal carcinoma were modified according to the associated pulmonary operation and the extent of cancer invasion.All thoracotomies for cardiectomy or esophagectomy were performed on the same side as the major pulmonary operation.Results All patients underwent a curative operation.There were no deaths or postoperative complications in the six synchronous lung tumor patients.In the eight pulmonary invasion patients,one patient died of respiratory failure 11 days after operation,and postoperative complications developed in four of them,but none was fatal.Six patients were still alive.Conclusions Curative gastric cardiectomy or esophagectomy associated with concurrent major pulmonary operation is not contraindicated in patients in good condition.In selected patients,when the operative procedures for cardiectomy or esophagectomy are appropriately modified to minimize the effect of the associated pulmonary operation,the treatment is associated with a low operative morbidity and mortality with an acceptable long-term survival.
文摘目的探讨食管癌患者胸、腹腔淋巴结的转移规律及其对生存预后的影响。方法选取经微创食管癌切除术(minimally invasive esophagectomy,MIE)治疗的食管鳞癌患者103例,按照日本食管肿瘤研究会(Japan Esophageal Cancer Research Association,JEOG)淋巴结分区的标准进行淋巴结清扫,统计淋巴结的转移情况,分析淋巴结转移情况对3年总生存率的影响。结果胸上段食管癌主要向左、右喉返神经旁淋巴结转移。胸中段食管癌呈现双向淋巴结转移。胸下段食管癌主要向胃左动脉旁和肝总动脉旁淋巴结转移。食管癌患者3年总生存率在病变长度、分化程度、浸润深度、肿瘤位置和淋巴结转移方面比较,差异均具有统计学意义(均P<0.05)。结论淋巴结转移是影响胸段食管癌患者术后效果的重要影响因素,结合病变位置情况,重点清扫相应部位的淋巴结,并可依据病变长度、分化程度、浸润深度、肿瘤位置及淋巴结转移判定远期预后。
