Combined nimotuzumab with chemoradiotherapy in patients with locally advanced or metastatic esophageal squamous cell carcinoma: A retrospective study

To observe the efficacy and toxicities of combined nimotuzumab with chemoradiotherapy as the first-line treatment to advanced esophageal squamous cell carcinoma (ESCC).The clinical data of 43 patients with local advanced or metastatic ESCC treated with nimotuzumab combined with chemoradiotherapy in our hospital were included in this retrospective study. The overall response, adverse events, overall survival (OS), and progressive-free survival (PFS) were analyzed.At 1 month after the treatment, objective response rate (complete response [CR] + partial response [PR]) was 65.12%, and disease control rate (CR + PR + stable disease [SD]) was 86.05%, with one patient (2.33%) showing CR, 27 (62.79%) patients with PR, 9 (20.93%) with SD, and 6 (13.95%) with progressive disease, respectively. The median OS was 15.5 months, and the median PFS was 8.83 months. Multivariate analysis showed that the patients with more cycles (>6 times) of nimotuzumab treatment had better PFS and OS than those with fewer cycles (≤6 times). Patients received high-dose radiation (>55 Gy) had a better PFS than those patients received low-dose radiation (≤55 Gy). Three patients suffered severe esophageal fistula, and three patients showed superficial skin erosion.Chemoradiotherapy in combination with more than 6 weekly doses of nimotuzumab (>1400 mg) had a survival benefit to the patients with advanced ESCC. High-dose radiation therapy for primary tumor has been confirmed to improve PFS in these patients. Patients treated with nimotuzumab showed no increased risk of adverse events.