title: Concurrent radiotherapy with gefitinib in elderly patients with esophageal squamous cell carcinoma: Preliminary results of a phase II study.
abstract: The survival rate associated with esophageal cancer is very poor due to diagnosis at advanced stages of disease and insensitivity to chemotherapy. This study investigated the efficacy of gefitinib combination with radiation in 20 elderly patients with esophageal squamous cell carcinoma (ESCC) who were not eligible for platinum-based chemotherapy. Immunohistochemistry was performed to analyze epidermal growth factor receptor (EGFR) expression, and the amplified refractory mutation system was used to detect EGFR mutations. Treatment response was assessed by endoscopy and computed tomography. Treatment toxicity was evaluated using the National Cancer Institute's Common Toxicity Criteria. The data showed that among these 20 patients, 5 experienced a complete response (CR), 13 a partial response (PR), and 2 had stable disease. The overall response rate (CR + PR) was 90%, the median overall survival (OS) was 14.0 months (95% confidence interval [CI]: 10.0-17.9 months), and the median progression-free survival was 7.0 months (95% CI: 0-17.2 months). Patients with good Eastern Cooperative Oncology Group performance status, never smoking, and EGFR mutated tumors had the best OS (14.0, 14.0, and 17.0 months, respectively). Treatment-related grade 3/4 toxicity occurred in five patients. No case of grade 3/4 impaired liver function or hematological toxicity was observed. Concurrent radiotherapy with gefitinib is effective and tolerable in elderly ESCC patients.
authors.affiliation: School of Medicine, Shandong University, Jinan, China.|Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Yuanda
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Xiaojiang
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Xinmin
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Jialei
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Gu
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Jinlin
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Wenyong
authors.initials: W
authors.lastname: Sun
authors.affiliation: Zhejiang Key Laboratory of The Diagnosis & Treatment Technology on Thoracic Oncology, Hangzhou, China.
authors.forename: Weimin
authors.initials: W
authors.lastname: Mao
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000201:enzymology / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods*; D002681:China; D004252:DNA Mutational Analysis; D018450:Disease Progression; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics / Q000378:metabolism; D004938:Esophageal Neoplasms / Q000201:enzymology / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D004945:Esophagoscopy; D005260:Female; D000077156:Gefitinib; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077156:Gefitinib
keywords: elderly patients; epidermal growth factor receptor; esophageal cancer; gefitinib; radiotherapy