• Concurrent chemoradiotherapy
• Immunotherapy
• Locally advanced esophageal squamous cell carcinoma
• Older patients
• Tislelizumab

• Humans
• Esophageal Squamous Cell Carcinoma/therapy
• Esophageal Squamous Cell Carcinoma/pathology
• Esophageal Squamous Cell Carcinoma/mortality
• Esophageal Squamous Cell Carcinoma/drug therapy
• Aged
• Esophageal Neoplasms/therapy
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/mortality
• Esophageal Neoplasms/drug therapy
• Chemoradiotherapy/methods
• Antibodies, Monoclonal, Humanized/administration & dosage
• Antibodies, Monoclonal, Humanized/therapeutic use
• Antibodies, Monoclonal, Humanized/adverse effects
• Male
• Female
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Clinical Trials, Phase II as Topic

• 82273083 National Natural Science Foundation of China
• 82272733 National Natural Science Foundation of China

• Elderly
• Esophageal squamous cell carcinoma
• Intensity-modulated radiotherapy
• Involved-field irradiation
• S-1

• Humans
• Tegafur/therapeutic use
• Aged
• Oxonic Acid/therapeutic use
• Oxonic Acid/administration & dosage
• Male
• Female
• Aged, 80 and over
• Esophageal Squamous Cell Carcinoma/radiotherapy
• Esophageal Squamous Cell Carcinoma/pathology
• Esophageal Squamous Cell Carcinoma/mortality
• Esophageal Neoplasms/radiotherapy
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/mortality
• Prospective Studies
• Drug Combinations
• Chemoradiotherapy
• Radiotherapy, Intensity-Modulated/adverse effects
• Radiotherapy, Intensity-Modulated/methods
• Survival Rate
• Antimetabolites, Antineoplastic/therapeutic use

• TD-SWYY-007 Jiangsu Province six talent peak innovation talent team project
• 320.6750.19194-60 Wu Jieping Medical Foundation Project
• KY202301-49 Beijing Baikouen Charity Foundation

• Concurrent chemoradiotherapy
• Esophageal squamous cell carcinoma
• Individualized treatment decision model
• Inoperable elder patients
• Radiotherapy

• Aged
• Humans
• Esophageal Squamous Cell Carcinoma/therapy
• Esophageal Squamous Cell Carcinoma/pathology
• Esophageal Neoplasms/diagnostic imaging
• Esophageal Neoplasms/therapy
• Carcinoma, Squamous Cell/therapy
• Carcinoma, Squamous Cell/drug therapy
• Prognosis
• Treatment Outcome
• Retrospective Studies

• Humans
• Quality of Life
• Prospective Studies
• Retrospective Studies
• Esophageal Neoplasms/therapy
• Chemoradiotherapy/adverse effects
• Dyspnea/etiology

Although the current conventional treatment strategies for esophageal carcinoma (EC) have been proven effective, they are often accompanied by serious adverse events. Therefore, it is still necessary to continue to explore new therapeutic strategies for EC to improve the clinical outcome of patients.

To elucidate the clinical efficacy of concurrent chemoradiotherapy (CCRT) with thalidomide (THAL) and S-1 (tegafur, gimeracil, and oteracil potassium capsules) in the treatment of EC as well as its influence on serum tumor markers (STMs).

First, 62 patients with EC treated at the Zibo 148 Hospital between November 2019 and November 2022 were selected and grouped according to the received treatment. Among these, 30 patients undergoing CCRT with cis-platinum and 5-fluorouracil were assigned to the control group (Con), and 32 patients receiving CCRT with THAL and S-1 were assigned to the research group (Res). Second, inter-group comparisons were carried out with respect to curative efficacy, incidence of drug toxicities, STMs [carbohydrate antigen 125 (CA125) and macrophage inflammatory protein-3α (MIP-3α)], angiogenesis-related indicators [vascular endothelial growth factor (VEGF); VEGF receptor-1 (VEGFR-1); basic fibroblast growth factor (bFGF); angiogenin-2 (Ang-2)], and quality of life (QoL) [QoL core 30 (QLQ-C30)] after one month of treatment.

The analysis showed no statistical difference in the overall response rate and disease control rate between the two patient cohorts; however, the incidences of grade I–II myelosuppression and gastrointestinal reactions were significantly lower in the Res than in the Con. Besides, the post-treatment CA125, MIP-3α, VEGF, VEGFR-1, bFGF, and Ang-2 Levels in the Res were markedly lower compared with the pre-treatment levels and the corresponding post-treatment levels in the Con. Furthermore, more evident improvements in QLQ-C30 scores from the dimensions of physical, role, emotional, and social functions were determined in the Res.

The above results demonstrate the effectiveness of THAL + S-1 CCRT for EC, which contributes to mild side effects and significant reduction of CA125, MIP-3α, VEGF, VEGFR-1, bFGF, and Ang-2 Levels, thus inhibiting tumors from malignant progression and enhancing patients’ QoL.

• Thalidomide
• Concurrent chemoradiotherapy
• Esophageal carcinoma
• Therapeutic effect
• Serum tumor markers

The purpose of this study was to analyze the clinical characteristics and prognosis of EPEC and to construct a prediction model based on the SEER database.

All EPECs from the SEER database were retrospectively analyzed. A comprehensive and practical nomogram that predicts the overall survival (OS) of EPEC was constructed. Univariate and multivariate Cox regression analysis was performed to explore the clinical factors influencing the prognosis of EPEC, and finally, the 1 -, 3 - and 5-year OS were predicted by establishing the nomogram. The discriminant and predictive ability of the nomogram was evaluated by consistency index (C-index), calibration plot, area under the curve (AUC), and receiver operating characteristic (ROC) curve. Decision curve analysis (DCA) was used to evaluate the clinical value of the nomogram.

A total of 3478 patients diagnosed with EPEC were extracted from the SEER database, and the data were randomly divided into the training group (n=2436) and the validation group (n=1402). T stage, N stage, M stage, surgery, chemotherapy, radiotherapy, age, grade, and tumor size were independent risk factors for 1 -, 3 - and 5-year OS of EPEC (P< 0.05), and these factors were used to construct the nomogram prediction mode. The C-index of the validation and training cohorts was 0.718 and 0.739, respectively, which were higher than those of the TNM stage system. The AUC values of the nomogram used to predict 1-, 2-, and 3-year OS were 0.751, 0.744, and 0.786 in the validation cohorts (0.761, 0.777, 0.787 in the training cohorts), respectively. The calibration curve of 1-, 2-, and 3-year OS showed that the prediction of the nomogram was in good agreement with the actual observation. The nomogram exhibited higher clinical utility after evaluation with the 1-, 2-, and 3-year DCA compared with the AJCC stage system.

This study shows that the nomogram prediction model for EPEC based on the SEER database has high accuracy and its prediction performance is significantly better than the TNM staging system, which can accurately and individually predict the OS of patients and help clinicians to formulate more accurate and personalized treatment plans.

• Chemoradiotherapy
• Chimioradiothérapie
• Elderly patients
• Esophageal neoplasms
• Patients âgés
• Prognosis
• Pronostic
• S1
• Tumeurs de l’œsophage

• chemoradiotherapy
• elderly patients
• esophageal cancer
• survival outcome
• treatment-related toxicity

To investigate the safety and efficacy of nimotuzumab combined with radiotherapy for elderly patients with non-resectable esophageal carcinoma (EC).

Eligible patients were aged 70 years or older and had treatment-naïve, 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.

From June 2011 to July 2016, 46 patients with stage II−IV EC with a median age of 76.5 years were enrolled. There were 10, 28 and 8 patients with stage II, 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%; grade 3, 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.

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.

• Nimotuzumab
• elderly
• esophageal neoplasm
• radiotherapy
• treatment outcome

Introduction: Intensive treatments can often not be administered to elderly patients with esophageal squamous cell carcinoma (ESCC), leading to a poorer prognosis. This multi-center phase II trial aimed to determine the toxicity profile and efficiency of S-1–based simultaneous integrated boost radiotherapy (SIB-RT) followed by consolidation chemotherapy with S-1 in elderly ESCC patients and to evaluate the usefulness of comprehensive geriatric assessment (CGA).

Patients and Methods: We prospectively enrolled 46 elderly patients (age ≥ 70 years) with histopathologically proven ESCC. The patients underwent pretreatment CGA followed by SIB-RT (dose, 59.92 Gy/50.4 Gy) in 28 daily fractions administered using intensity-modulated radiotherapy or volumetric-modulated arc therapy. S-1 was orally administered (40–60 mg/m²) concurrently with radiotherapy and 4–8 weeks later, for up to four 3-week cycles at the same dose.

Results: The median survival time was 22.6 months. The 1- and 2-year overall survival rates were 80.4 and 47.8%, respectively. The overall response rate was 78.3% (36/46). The incidence of grade 3–4 toxicities was 28% (13/46). The most common grade 3–4 toxicities were radiation esophagitis (5/46, 10.9%), nausea (4/46, 8.7%), anorexia (3/46, 6.5%), and radiation pneumonitis (3/46, 6.5%). There were no grade 5 toxicities. CGA identified that 48.8% of patients were at risk for depression and 65.5% had malnutrition.

Conclusion: Concurrent S-1 treatment with SIB-RT followed by 4 cycles of S-1 monotherapy yielded satisfactory tumor response rates and manageable toxicities in selected elderly patients with ESCC. Pretreatment CGA uncovered numerous health problems and allowed the provision of appropriate supportive care.

Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02979691.

• adjuvant
• aged
• chemoradiotherapy
• chemotherapy
• esophageal neoplasms
• geriatric assessment
• intensity-modulated
• radiotherapy

• Chemoradiotherapy
• Esophageal cancer
• Older patients

• Comprehensive geriatric assessment
• Concurrent chemoradiotherapy
• Consolidated chemotherapy
• Definitive chemoradiotherapy
• Elderly
• Esophageal cancer
• Esophagogastric junction cancer
• Intensity modulated radiotherapy
• Randomized controlled trial
• S-1
• Simultaneous integrated boost

• Adenocarcinoma/pathology
• Adenocarcinoma/therapy
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols/adverse effects
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Carcinoma, Squamous Cell/pathology
• Carcinoma, Squamous Cell/therapy
• Chemoradiotherapy
• Drug Combinations
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/therapy
• Esophagogastric Junction/drug effects
• Esophagogastric Junction/pathology
• Esophagogastric Junction/radiation effects
• Female
• Fluorouracil/administration & dosage
• Fluorouracil/adverse effects
• Humans
• Male
• Neoplasm Staging
• Outcome Assessment, Health Care/methods
• Outcome Assessment, Health Care/statistics & numerical data
• Oxonic Acid/administration & dosage
• Oxonic Acid/adverse effects
• Prospective Studies
• Radiotherapy, Intensity-Modulated/adverse effects
• Radiotherapy, Intensity-Modulated/methods
• Stomach Neoplasms/pathology
• Stomach Neoplasms/therapy
• Tegafur/administration & dosage
• Tegafur/adverse effects

• LC2016L04 Beijing Hope Run Special Fund of Cancer Foundation of China
• 2016YFC0904600 National Key Projects of Research and Development of China

The 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).

A 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.

Twenty-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.

The 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.

• chemoradiotherapy
• esophageal cancer
• geriatric assessment
• inclusion criteria
• older adults
• toxicity

• chemoradiotherapy
• crt
• esophageal neoplasms
• s-1

• Antimetabolites, Antineoplastic/therapeutic use
• Chemoradiotherapy
• Drug Combinations
• Esophageal Neoplasms/therapy
• Humans
• Oxonic Acid/therapeutic use
• Systematic Reviews as Topic
• Tegafur/therapeutic use
• Meta-Analysis as Topic