Case Report: Apatinib combined with IMRT concurrent therapy achieves rapid response and significantly prolongs progression-free survival in elderly patients with inoperable locally advanced esophageal squamous cell carcinoma.

Abstract

Patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC) typically have a poor prognosis, and concurrent chemoradiotherapy is the primary treatment modality. However, elderly patients often exhibit lower completion rates of concurrent chemoradiotherapy due to multiple comorbidities and reduced treatment tolerance, which directly affects their prognosis. Although apatinib combined with radiotherapy has demonstrated synergistic potential in treating certain solid tumors, its efficacy in elderly patients with LA-ESCC remains unclear. This case report involves an elderly patient with unresectable LA-ESCC who was treated with apatinib combined with intensity-modulated radiation therapy, The patient had comorbidities, including hypertension and diabetes, and declined chemotherapy. We implemented a treatment regimen consisting of intensity-modulated radiation therapy combined with low-dose apatinib. After nine sessions of radiotherapy, the patient's dysphagia significantly improved, and follow-up computed tomography revealed marked tumor shrinkage. As of July 2024, the patient has achieved a progression-free survival of 71 months without experiencing severe (Grade III/IV) adverse reactions. Therefore, apatinib combined with radiotherapy suggests potential benefits as a concurrent treatment option for elderly patients with unresectable LA-ESCC.