222PD - Efficacy of consolidation chemotherapy for clinical responder to concurrent chemoradiation in stage II-III squamous cancer of the esophagus

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Gastrointestinal tumours
Topics Anticancer agents
Oesophageal Cancer
Presenter Yongshun Chen
Citation Annals of Oncology (2016) 27 (suppl_9): ix68-ix85. 10.1093/annonc/mdw582
Authors Y. Chen1, J. Wang2, X. Cheng3, Q. Wang2, Y. Zhang3, W. Wang2, X. Wu3
  • 1Department Of Digestive Oncology, Renmin Hospital of Wuhan University, 430060 - Wuhan/CN
  • 2Department Of Radiation Oncology, 4th Hospital Hebei Medical University, 050011 - Shijiazhuang/CN
  • 3Department Of Radiation Oncology, Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, 450008 - Zhengzhou/CN

Abstract

Background

Concurrent chemoradiotherapy (CCRT) has become the standard of care in esophageal cancer patients who are not surgical candidates, but the benefit of consolidation chemotherapy is unknown. The aim of this study was to assess whether consolidation chemotherapy improves the outcome in responders after CCRT in patients with stage II-III squamous cancer of the esophagus.

Methods

The characteristics of patients treated with CCRT from September 2005 to September 2013 were reviewed, and those who achieved clinical complete response (CR) and partial response (PR) following CCRT were included in this study. Patients who received CCRT alone (observation group) were compared with patients who underwent CCRT followed by consolidation chemotherapy (consolidation group) with regard to overall survival, treatment failure and toxicity. Baseline characteristics were matched using the propensity score matching method.

Results

Of 666 patients recruited (234 observation, 432 consolidation), 249 (37.4%) had clinical stage II disease and 417 (62.6%) had stage III disease. Comparisons of the observation and consolidation groups in the matched population (234 patients in each group) showed median recurrence-free survival rates of 33.8 and 28.6 months (hazard ratio [HR], 1.08; 95%CI [confidence interval], 0.84 to 1.37; P = .549), and median overall survival rates of 44.5 and 41.8 months (HR, 1.03; 95%CI, 0.81 to 1.33; P = .788), respectively. For the patients with stage III disease, median OS did not differ between the observation and consolidation groups, the median OS was 35.6 and 33.7 months, respectively, P = .294. Of those with positive lymph nodes, the median OS was 31.2 months in the observation group and 34.9 months in the consolidation group, P = .638. More mild gastrointestinal reactions were noted in patients receiving consolidation chemotherapy. There was no significant difference in local/regional failure (49.1% vs. 45.3%) and distant failure (21.4% vs. 25.2%) between groups.

Conclusions

Consolidation chemotherapy did not increase survival or disease control for patients with stage II-III squamous cancer of the esophagus who respond to CCRT. The role of consolidation chemotherapy remains to be defined.

Clinical trial indentification

Legal entity responsible for the study

Zhengzhou University

Funding

Zhengzhou University

Disclosure

All authors have declared no conflicts of interest.