A phase II study of S-1 with concurrent radiotherapy in elderly patients with esophageal cancer

Ji, Yanjun; Du, Xuehui; Tian, Ye; Sheng, Liming; Cheng, Lei; Chen, Ying; Qiu, Guoqing; Xiao-fang, Zhou; Bao, Wei; Zhang, Danhong; Chen, Ming

doi:10.18632/oncotarget.20938

Cited by 15 publications

(11 citation statements)

References 25 publications

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“…In our systematic review, we found that the two prospective trials by Servagi-Vernat et al 8 had criteria excluding patients with weight loss of more than 15% from baseline. In another Phase II trial conducted by Ji et al, 10 weight loss was not used as an exclusion criterion, but over half of the patients (17/30, 56.7%) had <10% weight loss over nearly 6 months. Fourteen of the 24 retrospective studies did not reveal any results related to nutrition.…”

Section: Resultsmentioning

confidence: 99%

Concurrent chemoradiation therapy tailored to the older adults with esophageal cancer: state of the art and the future

Song

Fang

Wu³

2018

CIA

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PurposeThe aim of this study was to review the published literature addressing the question of whether geriatric assessment (GA) should be routinely applied in the treatment of older adults with esophageal cancer (EC) who have received definitive concurrent chemoradiotherapy (dCRT).Materials and methodsA literature search of PubMed, Embase, and Cochrane Library was performed. Studies that contained original data outlining the inclusion and exclusion criteria, treatment compliance rate, and severe toxicity reports were reviewed. Additionally, criteria from ongoing clinical trials in the World Health Organization and National Institutes of Health registries were reviewed to evaluate the utilization of GA-related domains in elderly EC patients who received dCRT.ResultsTwenty-nine studies were identified based on the selection criteria: five were single-arm prospective studies, and the other studies were retrospective studies. All studies used chronological age and performance status as basic descriptors for this subpopulation. The comorbidity index and the malnutrition level were mentioned in several studies. However, factors such as “Demographic data and social support,” “Psychology,” “Polypharmacy,” and “Geriatric syndromes” were not described in any of the included studies. Unfortunately, the results were similar for the registered clinical trials. Finally, treatment compliance and toxicity profile were found to be acceptable in selected elderly EC patients.ConclusionThe current experience for older adults with EC receiving dCRT is mainly based on the results of a series of retrospective studies. Ongoing clinical trials should routinely consider GA-related domains to select appropriate treatments for patients in the future.

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Section: Resultsmentioning

confidence: 99%

Concurrent chemoradiation therapy tailored to the older adults with esophageal cancer: state of the art and the future

Song

Fang

Wu³

2018

CIA

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“…Regarding the survival benefit of CCRT in elderly patients, a single-centre retrospective analysis (12) has previously shown that age 70 years or older is a poor prognostic factor (HR =2.099, P=0.001) for CCRT, however, all patients in the CCRT group were treated with the cisplatin plus 5-florouracil (FP) or paclitaxel plus cisplatin (TP) regimen in this study, and the results might indicate that two-drug intravenous chemotherapy in combination with concurrent radiotherapy does not provide survival benefit in elderly patients. In contrast, single-drug regimens, especially S-1 as a single oral agent, in combination with concurrent radiotherapy for elderly patients with esophageal cancer has received much focus in recent years (13)(14)(15). Therefore, for elderly patients aged 70 years or older, the potential survival benefit of CCRT, as well as optimal treatment regimens require further research (English Language Editor: J. Teoh)…”

Section: Discussionmentioning

confidence: 99%

Age plays an important role in the decision of definitive concurrent chemoradiotherapy (CCRT) for esophageal squamous cell carcinoma (ESCC): a propensity-score matched analysis of multicenter data (3JECROG R-02A)

Wang¹,

Wang²,

Ren³

et al. 2021

Transl Cancer Res TCR

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Background: To examine the survival benefit of definitive concurrent chemoradiotherapy (CCRT) compared to radiotherapy alone in patients with esophageal squamous cell carcinoma (ESCC) using a real-world patient population.Methods: This retrospective study included 2,762 patients with ESCC across ten medical centers in China from 2001 to 2017. A total of 1,133 patients received radiotherapy alone and 815 patients were treated with CCRT. The patient survival rates were assessed by propensity-score matching (PSM) and subgroup analysis. Results:The baseline characteristics were significantly different between the two groups, with the CCRT group showing a higher proportion of males, younger patients, cervical/upper thoracic cancers, and worse T and N stages. There were no significant differences in the clinical characteristics between the two groups after PSM. Before PSM, the median overall survival (OS) rates were 31.2 and 24.1 months in the CCRT and RT alone groups, respectively, demonstrating the superior therapeutic effects (TEs) of the CCRT.However, the median OS rates were not significantly different between the two groups after PSM (32.6 and 39.4 months in the CCRT and radiotherapy alone groups, respectively). The subgroup analyses revealed that the median OS was significantly better in the CCRT group compared to the radiotherapy alone group (37.5 vs. 25.1 months, respectively) in patients less than 70 years of age [hazard ratio (HR) 0.782, 95% confidence interval (CI): 0.657 to 0.932]. In contrast, in patients 70 years of age and older, the 5-year survival rate was poorer in the CCRT group (34.8%) compared to the radiotherapy alone group (73.4%). Therefore, CCRT was an independent poor prognostic risk factor (HR 3.206, 95% CI: 2.168 to 4.740).

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“…[25] In a prospective study of 30 patients received CCRT with S-1 (70 mg/m 2 ), the 2-years PFS and OS was 40.8% and 45.1%, respectively. [26] However, no study has directly compared the e cacy and safety of concurrent DP and S-1 regimens combined with RT in ESCC. In this study, the 3-year OS and 3-year PFS in the S-1 group was 34.7% and 25.0%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Chemoradiotherapy with S-1 Compared with Concurrent Chemoradiotherapy with Docetaxel and Cisplatin for Locally Advanced Esophageal Squamous Cell Carcinoma

Zhou

Wang

et al. 2020

Preprint

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Background: This retrospective study was to assess and compare the toxicity and efficacy of concurrent chemoradiotherapy (CCRT) with S-1 or docetaxel and cisplatin in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Methods: Patients who had locally advanced ESCC and received CCRT with S-1 (70mg/m2 twice daily on days 1-14, every 3 weeks for 2 cycles, S-1 group) or docetaxel (25mg/m2) and cisplatin (25mg/m2) on day 1 weekly (DP group) between 2014 and 2016 were retrospectively analyzed. Treatment-related toxicities, response rate, and survival outcomes were compared between groups. Results: A total of 175 patients were included in this study (72 in the S-1 group and 103 in the DP group). Baseline characteristics were well balanced between the two groups. The incidence of grade 3-4 adverse events were significantly lower in the S-1 group than in the DP group (22.2% versus 45.6%, p = 0.002). The objective overall response rate (complete response + partial response) was 68.1% in the S-1 group, and 73.8% the DP group (p = 0.497). The 3-year overall survival was 34.7% in the S-1 group, and 38.8% in the DP group (p = 0.422). The 3-year progression free survival in the DP group was higher than that in the S-1 group but without significant difference (33.0% versus 25.0%, p = 0.275). Conclusion: CCRT with S-1 is not inferior to CCRT with docetaxel and cisplatin and is better tolerated in in elderly patients with locally advanced ESCC.

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A phase II study of S-1 with concurrent radiotherapy in elderly patients with esophageal cancer

Cited by 15 publications

References 25 publications

Concurrent chemoradiation therapy tailored to the older adults with esophageal cancer: state of the art and the future

Concurrent chemoradiation therapy tailored to the older adults with esophageal cancer: state of the art and the future

Age plays an important role in the decision of definitive concurrent chemoradiotherapy (CCRT) for esophageal squamous cell carcinoma (ESCC): a propensity-score matched analysis of multicenter data (3JECROG R-02A)

Concurrent Chemoradiotherapy with S-1 Compared with Concurrent Chemoradiotherapy with Docetaxel and Cisplatin for Locally Advanced Esophageal Squamous Cell Carcinoma

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