Recombinant human endostatin combined with definitive chemoradiotherapy for patients with locally advanced esophageal carcinoma

Background: The efficacy and toxicity of recombinant human endostatin combined with docetaxel, cisplatin, and radiation therapies were evaluated in patients with locally advanced esophageal cancer. Methods: Between August 2010 and December 2012, 32 patients with clinical stage II and III squamous cell carcinoma of the esophagus were included in this retrospective analysis. The patients received recombinant human endostatin combined with definitive chemoradiotherapy. The Kaplan-Meier method was conducted to compute the survival time and progression- free survival time. Early and late toxicities were mainly scored based on the Common Terminology Criteria for Adverse Events 3.0. Results: A total of 21 and 11 patients had locally advanced stage II and III esophageal carcinoma, respectively. All patients received 60 Gy radiation. However, two only received one-cycle chemotherapy because of hematological toxicities. Complete response, partial response, stable disease, and progressive disease characteristics were observed in 17 (53.1%), 10 (31.3%), 3 (9.4%) and 2 (6.3%) patients, respectively, at 1 month post-treatment. After a median follow-up of 30 months, the median survival time was 22.0 months. The one-and three-year overall survival (OS) rates were 68.8% and 43.8%, respectively. The median progression-free survival (PFS) time was 16.0 months. The one-and three-year PFS rates were 56.3% and 31.3%, respectively. Hematologic toxicity, gastrointestinal toxicity, and treatment-related esophagitis were 16.1%, 10.7%, and 19.6%, respectively. Late toxicities, including esophagostenosis, were observed in six (19.6%) patients. Conclusions: The combined treatment modality can be a promising therapeutic option for patients with locally advanced esophageal squamous cell carcinoma. Additional prospective randomized control studies are necessary to confirm this finding.