Abstract
For the majority of inoperable esophageal cancer cases, chemoradiotherapy is the most suitable treatment option. Cetuximab may provide certain benefits, however, this can be an expensive therapy. Additionally, stereotactic body radiation therapy (SBRT) is typically contraindicated for esophageal cancer due to the potential for esophageal perforation and stenosis. The use of combined chemotherapy plus endostar with sequential SBRT for the treatment of esophageal squamous cancer has not been reported. In the current study, the case of a 71-year-old female with esophageal squamous cancer diagnosed 2 years prior is presented. Surgery and four cycles of cisplatin plus 5-fluorouracil chemotherapy had been administered. The patient showed recurrence at the paratracheal lymph node, exhibited severe dyspnea (grade III) and required a semi-liquid diet. Four cycles of the docetaxel, 5-fluorouracil and nedaplatin regimen plus endostar (3 mg; days 1–14; intravenously) with sequential SBRT (3300 cGy in 10 fractions) was administered. Following treatment, the symptoms of the patient completely disappeared, and objective efficacy evaluation indicated complete remission. At the time of writing, the patient is living without discomfort and the progression-free survival is >8 months. In conclusion, the present case indicates that combined treatment of chemotherapy and endostar with sequential stereotactic radiotherapy is a safe and effective option for the management of esophageal cancer.
Highlights
Esophageal cancer is not as common as lung, breast or colon malignancies, it is associated with a high mortalityKey words: esophageal cancer, stereotactic radiotherapy, chemotherapy, endostar rate, with an incidence rate that is close to its cancer‐specific mortality [1]
The case of a patient with esophageal cancer who responded to stereotactic body radiation therapy (SBRT) treatment is presented, including the use of combined chemotherapy plus endostar with sequential SBRT for the treatment of esophageal squamous cancer
Due to the mild symptoms associated with early‐stage esophageal cancer, the majority of patients cannot be diagnosed until they progress to advanced cancer
Summary
Esophageal cancer is not as common as lung, breast or colon malignancies, it is associated with a high mortality. Combination chemoradiotherapy has been associated with a high rate of complete pathological remission [5], the majority of targeted drugs, including avastin and cetuximab [6,7], have limited roles in the treatment of esophageal squamous cancer. A combination of chemotherapy and recombinant human endostatin (endostar) with sequential SBRT is shown to be successful as a salvage treatment for recurrent esophageal cancer accompanied by grade III dyspnea and difficulty in swallowing a semi‐liquid diet. As the life of the patient was in danger, methylprednisolone acetate was administered at 80 mg per day for temporary relief of the dyspnea, and this was followed by initial treatment with chemotherapy combined with endostar. The patient showed rapid improvement in dyspnea and dysphagia, and CT revealed that the paratracheal lymph node lesions had disappeared (Fig. 1C). The patient continued to exhibit no symptoms of dyspnea and dysphagia and has had no evidence of metastatic disease, with a progression‐free survival of >8 months at the time of writing
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