A randomized clinical trial on the antitumoral effects of low molecular weight heparin in the treatment of esophageal cancer.

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  • Additional Information
    • Source:
      Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0050222 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-4652 (Electronic) Linking ISSN: 00219541 NLM ISO Abbreviation: J Cell Physiol Subsets: MEDLINE
    • Publication Information:
      Publication: New York, NY : Wiley-Liss
      Original Publication: Philadelphia, Wistar Institute of Anatomy and Biology.
    • Subject Terms:
      Antineoplastic Agents/*therapeutic use ; Enoxaparin/*therapeutic use ; Esophageal Neoplasms/*drug therapy ; Esophageal Squamous Cell Carcinoma/*therapy; Antineoplastic Agents/adverse effects ; Chemoradiotherapy, Adjuvant ; Disease-Free Survival ; Enoxaparin/adverse effects ; Esophageal Neoplasms/mortality ; Esophageal Neoplasms/pathology ; Esophageal Squamous Cell Carcinoma/mortality ; Esophageal Squamous Cell Carcinoma/pathology ; Female ; Humans ; Iran ; Male ; Middle Aged ; Single-Blind Method ; Time Factors
    • Abstract:
      The current treatment approaches for esophageal cancer are associated with poor survival, and there are ongoing efforts to find new and more effective therapeutic strategies. There are several reports on the antitumoral effects of low-molecular-weight heparins (LMWHs). We have assessed the possible survival benefit of LMWHs in esophageal malignancies. This was a randomized, single-blind, multicenter, Phase II clinical trial on nonmetastatic esophageal cancer candidate for neoadjuvant chemoradiotherapy. Patients were randomly assigned to the chemoradiotherapy-only arm or chemoradiotherapy plus enoxaparin arm using 1:1 allocation. Radiotherapy was delivered in 1.8-Gy daily fractions to a dose of 50.4 Gy in both groups. Paclitaxel 50 mg/m 2 and carboplatin (AUC 2) were administered weekly, concurrent with radiotherapy. In the intervention group, patients received enoxaparin (40 mg) and chemoradiation daily. 4-6 weeks after treatment, all patients underwent esophagectomy. After a median follow up of 7 months, estimated 1 year disease-free survival (DFS) in the intervention group was 78.9% and was 70% in the control groups ( p = 0.5). Toxicity from the experimental treatment was minimal, and there were no treatment-related deaths. A pathologically complete response in intervention and control group was 64.8% and 62.5%, respectively ( p = 0.9). There was a nonsignificant trend toward improved survival by the addition of enoxaparin to the concurrent chemoradiotherapy regimen. However, 1 y DFS of both groups were high as expected. A longer follow-up and a larger sample size are required.
      (© 2018 Wiley Periodicals, Inc.)
    • Contributed Indexing:
      Keywords: anti-tumoral effects; clinical trail; esophageal cancer; low molecular weight heparin (LMWH)
    • Accession Number:
      0 (Antineoplastic Agents)
      0 (Enoxaparin)
    • Publication Date:
      Date Created: 20181027 Date Completed: 20200316 Latest Revision: 20200316
    • Publication Date:
      20221213
    • Accession Number:
      10.1002/jcp.27177
    • Accession Number:
      30362518