title: Clinical Observation of Bevacizumab Combined with S-1 in the Treatment of Pretreated Advanced Esophageal Carcinoma.
abstract: Objective To investigate the clinical effects and safety of bevacizumab combined with S-1 as the second-line treatment of recurrent and/or metastatic esophageal cancer after chemoradiation. Methods Patients with recurrent or metastatic esophageal cancer after chemoradiation were treated with bevacizumab and S-1. Bevacizumab was used by intravenous infusion, 7.5mg/kg body weight on day 1; S-1 was used by oral at 80mg/m2·d on day 1-14, 21 days as a cycle of treatment and repeated until either pro- gressive disease or intolerable toxicity occurred. Chest CT were performed and RECIST 1.1 was used for response evaluation. Kaplan-Meier method was used for survival analysis. Side effects were recorded and analyzed. Results Totally 78 patients were enrolled in the study, including 67 squamous cell carcinoma and 11 adenocarcinoma histologically. The overall response (CR+PR) rate was 22.4% (17/76) and disease control (CR+PR+SD) rate was 61.8% (47/76) respectively. The median follow-up time was 20 months (range from 9 to 44 months). The median progression-free survival (PFS) was 4.9 months (95% CI 4.4-5.5) and the median overall survival (OS) was 8.1 months (95% CI 7.6-9.2). The median PFS and OS of patients with metastasis diseases were 6.2 months (95% CI 3.3 to 6.3) and 8.5 months (95% CI 5.8 to 11.2), where PFS was longer than that of patients with local regional recurrence (median 5.0 months, 95% CI 3.0 to 5.5, P=0.017) and OS was longer than that of patients with regional disease and metastasis (median 8.0 months, 95% CI 4.6 to 9.5, P=0.010). The common adverse effects were mild to moderate neutropenia (84.2%), grade I-II hand and foot syndrome (51.3%), grade I-II nausea (48.7%), mild epistaxis (30.1%) and mild vomiting (14.5%). Esophageal bleeding occurred in 7.9% of patients. One patient (1.3%) died from massive bleeding which was caused by esophageal perforation. Conclusion Bevacizumab combined with S-1 was effective and safe for esophageal cancer patients who had recurrent or metastatic diseases after chemoradiation.
authors.affiliation: Department of Oncology, Qingdao Cancer Hospital, Qingdao, Shandong 266042, China.
authors.forename: Keke
authors.initials: K
authors.lastname: Nie
authors.affiliation: Department of Oncology, Qingdao Cancer Hospital, Qingdao, Shandong 266042, China.
authors.forename: Chuanxin
authors.initials: C
authors.lastname: Geng
authors.affiliation: Department of Oncology, Qingdao Cancer Hospital, Qingdao, Shandong 266042, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Oncology, Qingdao Cancer Hospital, Qingdao, Shandong 266042, China.
authors.forename: Shichao
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Oncology, Qingdao Cancer Hospital, Qingdao, Shandong 266042, China.
authors.forename: Zhongfa
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Oncology, Qingdao Central Hospital, 2nd Affiliated Hospital of Qingdao University, Qingdao,Shandong 266042, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Oncology, Qingdao Central Hospital, 2nd Affiliated Hospital of Qingdao University, Qingdao,Shandong 266042, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zou
authors.affiliation: Department of Oncology, Qingdao Central Hospital, 2nd Affiliated Hospital of Qingdao University, Qingdao,Shandong 266042, China.
authors.forename: Youxin
authors.initials: Y
authors.lastname: Ji
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage* / Q000009:adverse effects; D004338:Drug Combinations; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D005641:Tegafur / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D000068258:Bevacizumab; D010094:Oxonic Acid