Elsevier

Surgical Oncology

Volume 26, Issue 4, December 2017, Pages 333-337
Surgical Oncology

Beta-elemene treatment is associated with improved outcomes of patients with esophageal squamous cell carcinoma

https://doi.org/10.1016/j.suronc.2017.07.002Get rights and content

Highlights

  • β-elemene were first studied in patients with esophageal cancer.

  • β-elemene provided survival benefits in patients with esophageal cancer.

  • β-elemene reduced toxicities associated with chemoradiotherapy.

  • β-elemene was an independent prognostic factor in patients with esophageal cancer.

Abstract

Purpose

To investigate the therapeutic effects of concurrent preoperative β-elemene treatment in patients with esophageal squamous cell carcinoma who received concurrent chemoradiotherpay followed by surgery.

Method

The clinicopathological parameters and outcomes of 102 patients with esophageal squamous cell carcinoma were studied and compared between patients treated with and without β-elemene.

Results

β-elemene treatment could prolong the overall survival and progression-free survival. The 3-year overall survival rate was also increased by β-elemene treatment. β-elemene treatment was an independent prognostic factor for both overall survival and progression-free survival. Occurrence of toxicities associated with chemoradiotherapy was decreased by β-elemene treatment.

Conclusions

Findings in this study suggested that β-elemene treatment provided survival benefits and reduced chemoradiotherapy-associated toxicities in patients with esophageal squamous cell carcinoma.

Introduction

Esophageal cancer is the eighth most common cancer worldwide [1], and causes more than 400,000 deaths annually [2]. China is one of the countries with highest morbidity and mortality of esophageal cancer which causes 15,000 deaths per year [3]. According to the types of cells involved, the main subtype of esophageal cancer in China is esophageal squamous cell carcinoma [4]. In the past several decades, preoperative concurrent chemoradiotherapy followed by radical surgery has been widely studied for treating esophageal cancer and is considered to be one of the standard managements for resectable locally advanced esophageal cancer because of its survival benefits [5], [6]. This tri-modality therapy leads to tumor downstaging and increased likelihood of achieving a complete surgical resection [7]. However, shortcomings of the tri-modality therapy still exist, such as increased posteroperative morbidity and mortality [6]. So, development of new treatment is still in a great demand.

β-elemene, isolated from the Chinese medicinal herb Curcuma wenyujin, is an broad-spectrum antitumor drug and exhibits antitumor activity in vitro and in vivo [8]. It has been approved as a medical treatment in clinical practice by the State Administration of Pharmacy of China and Ministry of Health People's Republic of China [8]. In the past several decades, β-elemene was widely studied basically and clinically in China [9]. However, so far, no clinical research about β-elemene treatment with special focus on esophageal squamous cell carcinoma has been done. In this study, we retrospectively analyzed the use of β-elemene in patients with esophageal squamous cell carcinoma and assessed the survival benefits.

Section snippets

Methods and materials

This study was approved by the institutional ethic committee at the First Affiliated Hospital of Zhengzhou University and performed in compliance with the Helsinki Declaration.

Clinical characteristics of the patients

Table 1 showed the baseline characteristics of the patients with esophageal squamous cell carcinoma. A total of 102 patients who received concurrent chemoradiotherapy followed by curative surgery were included in this study according to aforementioned inclusion criteria. Among them, 89 patients (87%) were male and 13 patients (13%) were female. In total, 48 patients (47%) received β-elemene treatment. The differences of the clinical parameters between the patients treated with and without

Discussion

In the past several decades, Traditional Chinese Medicine has been widely studied basically and clinically as adjuvant therapy for treating cancer [10], including esophageal cancer [11], [12], [13]. β-elemene, as a herbal drug approved by the State Administration of Pharmacy of China and Ministry of Health People's Republic of China [8], was widely used clinically in China in cancer treatment as adjuvant therapy [14], [15], [16], [17], including esophageal squamous cell carcinoma treatment [18]

Conflict of interests

None.

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