Article Abstract

Evaluation of clinical efficacy after combinational treatment of esophageal cancer using target artery perfusion of verapamil and chemotherapy

Authors: Yabei Liu, Liting Qian, Kelong Ma, Tengyue Zhang, Gaofei Fan, Yang Wu, Tian Li, Pingsheng Fan, Zhaoshen Li


Background: This study aimed to investigate the clinical efficacy of target artery perfusion of verapamil combined with chemotherapy in treating esophageal cancer (EC).
Methods: A total of 46 patients with EC (stage III and IV) were treated with verapamil combined with chemotherapy via target artery infusion. Two to four courses per month of the treatment were administrated. Imaging modalities used in staging EC before and after treatment include gastroscopy/endoscopic ultrasonography, computed tomography (CT) combined with 64-detector-row gemstone spectral imaging/3.0-T magnetic resonance imaging (MRI). The clinical beneficial rate and survival time were also evaluated.
Results: Out of 46 patients, 2 cases achieved complete remission (CR) and 39 cases achieved partial remission (PR). There were 3 cases had no change and 2 cases with progressive disease. The overall effective rate (CR + PR) was 89.13%. After treatment, dysphagia in 42 patients was significantly improved except 5 cases with narrow type. A total of 11 cases with hoarseness caused by recurrent laryngeal nerve paralysis before therapy recovered normal voice and another 7 cases were completely relieved. Forty-five patients were treated with 1 course of radiotherapy, and 1 patient was treated by operation after 2 to 4 courses of treatment and clinical tumor stage had decreased. A total of 42 patients (91.30%) survived for more than a year, 24 patients (52.17%) survived for more than 2 years, and 12 patients (26.09%) survived for more than 3 years. Patients also achieved better Karnofsky performance status (KPS) scores, body weight, and positive clinical benefit of the dosage of analgesics, which were 91.30% (42/46), 52.17% (24/46), and 66.67% (4/6), respectively. No significant complication was observed before and after verapamil.
Conclusions: Target artery infusion of verapamil combined with chemotherapy drug significantly reduced the clinical tumor stage of advanced EC (≥ stages III), improved the quality of life, and prolonged the survival time. And patients regained the opportunity of radical radiotherapy or surgery when the clinical tumor stages were decreased.