1
|
Kai K, Nakashima K, Kawakami H, Takeno S, Hishikawa Y, Ikenoue M, Hamada T, Imamura N, Shibata T, Noritomi T, Sasaki F, Nakamura Y, Nanashima A. Clinical Impact of the Charlson Comorbidity Index on the Efficacy of Salvage Photodynamic Therapy Using Talaporfin Sodium for Esophageal Cancer. Intern Med 2024; 63:903-910. [PMID: 37558484 PMCID: PMC11045372 DOI: 10.2169/internalmedicine.1907-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/02/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction Photodynamic therapy (PDT) is a salvage treatment for local failure after chemoradiotherapy for esophageal cancer. Salvage PDT is the treatment available for vulnerable patients with various comorbidities at risk of salvage esophagectomy. This study assessed the impact of the Charlson comorbidity index (CCI) on the outcomes of salvage PDT using talaporfin sodium (TS) for esophageal cancer. Metohds Consecutive patients with esophageal cancer who underwent salvage TS-PDT from 2016 to 2022 were included in this retrospective study. We investigated the local complete response (L-CR), progression-free survival (PFS) and overall survival (OS) and evaluated the relationship between the CCI and therapeutic efficacy. Results In total, 25 patients were enrolled in this study. Overall, 12 patients (48%) achieved an L-CR, and the 2-year PFS and OS rates were 24.9% and 59.4%, respectively. In a multivariate analysis, a CCI ≥1 (p=0.041) and deeper invasion (p=0.048) were found to be significant independent risk factors for not achieving an L-CR. To evaluate the efficacy associated with comorbidities, we divided the patients into the CCI=0 group (n=11) and the CCI ≥1 group (n=14). The rate of an L-CR (p=0.035) and the 2-year PFS (p=0.029) and OS (p=0.018) rates in the CCI ≥1 group were significantly lower than those in the CCI=0 group. Conclusion This study found that the CCI was negatively associated with the efficacy of salvage TS-PDT for esophageal cancer.
Collapse
Affiliation(s)
- Kengo Kai
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
- Department of Anatomy, Histochemistry and Cell Biology, Faculty of Medicine, University of Miyazaki, Japan
| | - Koji Nakashima
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Hiroshi Kawakami
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Shinsuke Takeno
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
| | - Yoshitaka Hishikawa
- Department of Anatomy, Histochemistry and Cell Biology, Faculty of Medicine, University of Miyazaki, Japan
| | - Makoto Ikenoue
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
- Department of Anatomy, Histochemistry and Cell Biology, Faculty of Medicine, University of Miyazaki, Japan
| | - Takeomi Hamada
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
| | - Naoya Imamura
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University, Japan
| | | | - Fumisato Sasaki
- Department of Gastroenterology, Ikeda Hospital, Japan
- Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Japan
| | - Yoshitaka Nakamura
- Department of Gastroenterology, Kagoshima Prefectural Oshima Hospital, Japan
| | - Atsushi Nanashima
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
| |
Collapse
|
2
|
Yasui S, Yoshida A, Takata M, Kamitani Y, Nakada Y, Kurumi H, Ikebuchi Y, Kawaguchi K, Yashima K, Isomoto H. Rheumatoid Arthritis Symptoms Diagnosed by Rheumatic Immune-related Adverse Events Caused by Nivolumab in a Patient with Esophageal Cancer. Intern Med 2023; 62:215-220. [PMID: 35732452 PMCID: PMC9908395 DOI: 10.2169/internalmedicine.9663-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This report described the case of a 70-year-old man who developed polyarthralgia after nivolumab treatment for recurrent esophageal cancer. Arthritis developed after initiating nivolumab therapy, and the patient tested positive for rheumatoid factor and anti-citrullinated peptide antibodies. The hand and elbow joints were already deformed, suggesting that he had had rheumatoid arthritis for several years and that the symptoms had only become apparent after nivolumab administration. This patient had rheumatoid arthritis, which was diagnosed as a nivolumab-induced rheumatic immune-related adverse event (rh-irAEs). Arthralgia during nivolumab administration can occur in rh-irAE cases. Patients should be assessed for autoimmune diseases before initiating immune checkpoint inhibitors.
Collapse
Affiliation(s)
- Sho Yasui
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan
| | - Akira Yoshida
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan
| | - Miki Takata
- Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori University, Japan
| | - Yu Kamitani
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan
| | - Yusuke Nakada
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan
| | - Hiroki Kurumi
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan
| | - Yuichiro Ikebuchi
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan
| | - Koichiro Kawaguchi
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan
| | - Kazuo Yashima
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan
| | - Hajime Isomoto
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan
| |
Collapse
|