Efficacy of Concurrent Chemoradiotherapy With S-1 vs Radiotherapy Alone for Older Patients With Esophageal Cancer

Ji, Yanjun; Du, Xianghui; Zhu, Weiguo; Yang, Yanguang; Ma, Jun; Zhang, Li; Li, Jiancheng; Tao, Hua; Xia, Jianhong; Yang, Haihua; Huang, Jin; Bao, Yong; Du, Dexi; Liu, Degan; Wang, Xiusheng; Li, Chaoming; Yang, Xinmei; Zeng, Ming; Liu, Zhigang; Zheng, Wen; Pu, Juan; Chen, Jun; Hu, Weijian; Li, Peijing; Wang, Jin; Xu, Yujin; Zheng, Xiaomin; Chen, Jianxiang; Wang, Wanwei; Tao, Guangzhou; Cai, Jing; Zhao, Jizhong; Zhu, Jun; Jiang, Ming; Yan, Yan; Xu, Guoping; Bu, Shi; Song, Binbin; Xie, Ke; Huang, Shan; Zheng, Yuanda; Sheng, Liming; Lai, Xiaojing; Chen, Ying; Liu, Cheng; Hu, Xiao; Ji, Wenhao; Fang, Min; Kong, Yue; Yu, Xiaofu; Li, Huizhang; Li, Runhua; Shi, Lei; Shen, Wei; Zhu, Chaonan; Lv, Junwei; Huang, Rong; He, Hong; Chen, Ming

doi:10.1001/jamaoncol.2021.2705

Cited by 62 publications

(79 citation statements)

References 37 publications

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“…Moreover, the close relationship between blood vessels and amyloid plaques (Nortley et al, 2019) suggests that vascular-wall proteoglycans may be associated with Aβ deposits or NFTs in nearby plaques. Different DSPGs were also shown to have different binding affinities for amyloid (Buée et al, 1993). Taken together, this evidence supports that DSPGs play an important role in the formation of amyloid plaques and the pathogenesis of AD.…”

Section: The Ecm Is Involved In the Formation And Degradation Of Aβ Plaquessupporting

confidence: 63%

Role of the Extracellular Matrix in Alzheimer’s Disease

Sun

Jiang

et al. 2021

Front. Aging Neurosci.

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Alzheimer’s disease (AD) is a neurodegenerative disease with complex pathological characteristics, whose etiology and pathogenesis are still unclear. Over the past few decades, the role of the extracellular matrix (ECM) has gained importance in neurodegenerative disease. In this review, we describe the role of the ECM in AD, focusing on the aspects of synaptic transmission, amyloid-β-plaque generation and degradation, Tau-protein production, oxidative-stress response, and inflammatory response. The function of ECM in the pathological process of AD will inform future research on the etiology and pathogenesis of AD.

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Section: The Ecm Is Involved In the Formation And Degradation Of Aβ Plaquessupporting

confidence: 63%

Role of the Extracellular Matrix in Alzheimer’s Disease

Sun

Jiang

et al. 2021

Front. Aging Neurosci.

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“…The incidence of ≥grade 3 toxicities in each side effect was less than 10%, which was comparable to previous studies with single S1 and much lower than that with doublet agents in dCRT in elderly ESCC patients ( 21 – 25 ). The median survival time in present trial was favorable (26.1 months) and comparable to previous similar studies (22.6–25.7 months) ( 21 – 24 ).…”

Section: Discussionsupporting

confidence: 90%

“…The long-term results of a retrospective analysis of elderly ESCC patients treated with S-1 concurrent with radiotherapy showed satisfactory survival outcomes and tolerable toxicities ( 21 ). Furthermore, several prospective trials also showed mild toxicity and satisfactory efficacy in elderly ESCC patients treated with S-1 concurrent with radiotherapy ( 22 – 24 ). In our prospective trial, S-1 concurrent with definitive radiotherapy was well tolerated in either elderly patients or patients with serious comorbidities.…”

Section: Discussionmentioning

confidence: 93%

Long-Term Results of a Phase 2 Study of Definitive Chemoradiation Therapy Using S-1 for Esophageal Squamous Cell Carcinoma Patients Who Were Elderly or With Serious Comorbidities

et al. 2022

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BackgroundThe optimal evidence-based management for the subsets of locally advanced esophageal squamous cell carcinoma (ESCC) patients who rejected or were intolerant to intravenous chemotherapy due to old age or serious comorbidities is currently lacking. This study aimed to assess the safety and local control rate (LCR) of S-1 (tegafur–gimeracil–oteracil potassium) combined with radiotherapy in these subsets of ESCC patients.MethodsLocally advanced ESCC patients who rejected or were intolerant to intravenous chemotherapy due to age >75 years or serious comorbidities were enrolled in a prospective, single-arm, phase 2 trial. The patients were treated with definitive concurrent chemoradiotherapy with S-1, which was administered orally twice daily for 28 days. The radiotherapy dose was 61.2 Gy delivered in 34 fractions. The primary end-point was the 3-year LCR.ResultsOne hundred five ESCC patients were recruited between March 2013 and October 2015. At the median follow-up of 73.1 months (IQR 65.5–81.4 months), 3-year LCR was 61.1%, and 1, 3, and 5-year overall survival was 77.9, 42.3, and 24.8% respectively. For safety analysis, ≥grade 3 acute adverse events included thrombocytopenia (6.7%), leukopenia (2.9%), anemia (1.0%), anorexia (1.0%), fatigue (10.5%), hiccup (1.0%), pneumonitis (4.8%), and esophagitis (3.8%). Two patients (1.9%) died of late esophageal hemorrhage, and one patient (1.0%) died of late radiation-induced pneumonitis.ConclusionS-1 is a promising regimen in concurrent chemoradiotherapy with low toxicity and a favorable LCR in ESCC patients who rejected or were intolerant to intravenous chemotherapy due to old age or serious comorbidities.Clinical Trial RegistrationClinicalTrials.gov, NCT01831531.

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“…The results were consistent with a recently published phase III trial among elderly cohorts which reported a median PFS of 18.7 vs 9.5 months. 29 However, our trial achieved better PFS (25.7 vs 13.9 months) with fewer side PFS was obtained with CCRT treatment. [30][31][32][33] Given the influence of sex on survival, the high proportion of female patients (39.5%) may contribute to better results in the present study.…”

Section: Discussionmentioning

confidence: 52%

Comparison of concurrent chemoradiotherapy with radiotherapy alone for locally advanced esophageal squamous cell cancer in elderly patients: A randomized, multicenter, phase II clinical trial

Liu

Zheng

et al. 2022

Intl Journal of Cancer

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This randomized, multicenter, phase II clinical trial was performed to compare the safety and efficacy of concurrent chemoradiotherapy using S-1 (CCRT) with radiotherapy alone (RT) for elderly patients with locally advanced esophageal squamous cell carcinoma (ESCC). All eligible patients were randomly assigned to the CCRT group or the RT group at a 1:1 ratio. The CCRT group received 50.4 Gy radiotherapy concurrent with S-1 and the RT group received 59.4 Gy radiotherapy alone. The primary endpoints were toxicity and the overall response rate (ORR), and the secondary endpoints were overall survival (OS) and progression-free survival (PFS). In total, 157 elderly patients with ESCC were recruited from December 2016 to March 2020. By June 2021, the median follow-up duration had reached 38 months. No grade 5 toxicities occurred in either group and the overall rate of severe toxicities (≥grade 3) was higher in the CCRT group (19.2% vs 7.6%; P = .037), particularly neutropenia (7.7% vs 1.3%; P = .06). The CCRT group presented a significantly higher ORR (83.3% vs 68.4%; P = .009) and prolonged PFS (25.7 vs 13.9 months; P = .026) than the RT group. The median OS was 27.3 months in the CCRT group and 19.

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Efficacy of Concurrent Chemoradiotherapy With S-1 vs Radiotherapy Alone for Older Patients With Esophageal Cancer

Cited by 62 publications

References 37 publications

Role of the Extracellular Matrix in Alzheimer’s Disease

Role of the Extracellular Matrix in Alzheimer’s Disease

Long-Term Results of a Phase 2 Study of Definitive Chemoradiation Therapy Using S-1 for Esophageal Squamous Cell Carcinoma Patients Who Were Elderly or With Serious Comorbidities

Comparison of concurrent chemoradiotherapy with radiotherapy alone for locally advanced esophageal squamous cell cancer in elderly patients: A randomized, multicenter, phase II clinical trial

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