630P - Concurrent neoadjuvant chemoradiotherapy for Siewert II and III adenocarcinoma of the gastroesophageal junction: short term efficacy

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Oesophageal Cancer
Gastric Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Qun Zhao
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors Q. Zhao1, Y. Li1, J. Wang2, J. Zhang2, X. Qiao2, Y. Tian1, P. Yang1, B. Tan1, L. Fan1, G. Shi3, Q. Xu3, R. Li3, Y. Liu4, Z. Jiao1, X. Zhao1, D. Wang1, Z. Zhang1, Y. Liu1
  • 1Third Surgery Department, Forth Hospital of Hebei Medical University, 050011 - Shijiazhuang/CN
  • 2Radiotherapy Department, Forth Hospital of Hebei Medical University, 050011 - Shijiazhuang/CN
  • 3Ct/mri Department, Forth Hospital of Hebei Medical University, 050011 - Shijiazhuang/CN
  • 4Pathology Department, Forth Hospital of Hebei Medical University, 050011 - Shijiazhuang/CN

Abstract

Aim

This study was conducted to investigate the efficacy and safety of applying concurrent neoadjuvant chemoradiotherapy in treatment of adenocarcinoma of the gastroesophageal junction.

Methods

From August 2012 to August 2013, a total of 76 patients with resectable adenocarcinoma of the gastroesophageal junction (T3/4,N + ,M0) were recruited and randomly assigned to a concurrent chemoradiotherapy group (n = 36) or a surgery group (n = 40). Patients in the chemoradiation group received oral administration of capecitabine (1000 mg/m2, bid, for 14 days), and intravenous administration of oxaliplatin (130 mg/m2 on day 1, q3w, for 2 courses). A total of 45 Gy radiations were administered during a period of 5 weeks (25 sessions). Patients in the surgery group received surgical intervention alone. This study was approved by the ethics committee and registered in ClinicalTrials.gov(NCT01962246).

Results

In the concurrent chemoradiotherapy group, the overall response rate was 55.6% (20/36), the tumor control rate was 100%, and pathological complete response was achieved in 6 of 36 patients (16.7%). The proportion of patients who achieved R0 resection in the concurrent chemoradiotherapy group and surgery group was 100% and 80% (32/40), respectively (P < 0.05). In the chemoradiotherapy group, only 6 patients developed grade 3 adverse events, and treatment was discontinued or the dose was adjusted. The major hematological toxicities in the chemoradiotherapy group included leukopenia, neutropenia, anemia, and thrombocytopenia, and non-hematological toxicities included nausea, vomiting, and anorexia (all grade). Chemoradiation related death was not observed. Peri-operative complications of patients in the two groups [n (%)].

Complications Concurrent chemoradiotherapy (n = 36) Surgery alone (n = 40)
Lymphatic fistula 1 (27.8) 0
Pleural effusion and ascites 1 (27.8) 0
Esophageal-jejunal anastomotic fistula 0 1 (25)
Wound dehiscence 0 1 (25)

Conclusions

Administration of concurrent neoadjuvant chemoradiotherapy increased the rate of R0 resection and well tolerated in patients with Siewert II or III adenocarcinoma of the gastroesophageal junction. A phase III trial is planned to further proof this concept.

Disclosure

All authors have declared no conflicts of interest.