233P - Intensive neoadjuvant chemotherapy followed by chemoradiation and intraluminal HDR brachytherapy in esophageal cancer

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer Agents
Oesophageal Cancer
Surgical Oncology
Presenter Farhad Samiei
Citation Annals of Oncology (2016) 27 (suppl_9): ix68-ix85. 10.1093/annonc/mdw582
Authors F. Samiei1, S. Sarbaz2, N. Samiei3, N. Farzi3, M. Forootan4, S. Babak3, E. Karimzadeh3
  • 1Institute Cancer, Central Cancer Institute of Imam Khomeini Hospital, 17339 - Tehran/IR
  • 2Radiation Oncology, Novin research institute, 17339 - Tehran/IR
  • 3Radiation Oncology, Laleh Hospital, 17339 - Tehran/IR
  • 4Gastroenterology Research Center, Taleghani Hospital, 17339 - Tehran/IR

Abstract

Background

Esophageal cancer optimized treatment is under debate. Treatment failure in the majority of patients is local residue or recurrence mean while the systemic failure is important too.so the role of intensified strategy combining neoadjuvant chemotherapy with maximal local therapy(chemoradiation plus intraluminal brachytherapy) would be hopeful.

Methods

We proposed to evaluate esophageal cancer patients in response to two treatment approach: A neoadjuvant chemotherapy (NCT) by docetaxel, cisplatin, 5FU B-NCT by DCF followed by CRT and consolidation by intraluminal HDR brachytherapy (BR). Between Sept 2007 and Sept 2011, seventy five non-metastatic patients who were not candidates for surgery. because of technical or medical limitation entered to study.The patients divided 2 groups: Group I:Relative localized disease(T1-2N1) Group II: Relative advanced disease(T3-T4 any N) In both groups, we used treatment A&B randomly, NCT scheduled for 4 cycle in both groupsfollowed by CRT(external beam 50Gy concurrentlywith 5FU or capecitabine). HDR brachytherapy delivered in 3 weekly sessions.The patients subgroups could summerized: Group I:IA(NCT+CRT), IB(NCT+CRT+BR) Group II:IIA(NCT+CRT), IIB(NCT+CRT+BR)

Results

All 75 cases analysed (mean follow up: 32 months). The response rate(RR) and disease free survival (DFS) are shown:rn

Table: 233P

rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
SubgroupsNo of casesRR(%)cases(%) 1 year DFScases(%) 3 year DFS
IA1712(70)10(58)7(41)
IB1714(82)12(70)10(58)
IIA219(43)7(33)4(19)
IIB2012(60)9(45)6(30)
Total7547(62)38(50)27(36)
rn

Conclusions

Both stages of disease and treatment consolidation by HDR brachytherapy show significant effect on the outcome. We recommend for all patients to receiveNCT and CRT followed by HDR-BR.

Clinical trial indentification

Legal entity responsible for the study

Emam Khomeini Hospital, Research Institute Cancer

Funding

Emam Khomeini Hospital, Research Institute Cancer

Disclosure

All authors have declared no conflicts of interest.