Abstract 2403
Background
For patients (pts) with esophageal (ES) cancer and fragility or limiting comorbidities resulting in contraindications for surgery, CRT is the only treatment option with curative potential. In this scenario, the best evidence is CRT followed by consolidation chemotherapy based on fluoropyrimidine/platin combination (RTOG 98-01/PRODIGE 5). However, definitive CRT with CP is frequently used due to better tolerance and convenience, despite the lack of phase III trials.
Methods
Consecutive frail/comorbid pts with ES cancer were retrospectively selected. Primary objective was to compare response rate (RR) by RECIST 1.1, disease-free survival (DFS) and overall survival (OS) between CRT followed by consolidation with 2 cycles of CF and definitive CRT with weekly CP (carboplatin AUC 2 and paclitaxel 50mg/m2). Radiotherapy dose: 50,4 Gy. Secondary objectives: prognostic factors and safety. Descriptive statistics were used for population characteristics analysis and Kaplan-Meier curves, Log-Rank Test and Cox Regression for survival analysis.
Results
From May, 2010 to May, 2018, 99 pts were treated, 18 (18.2%) with CF and 81 (81.8%) with CP. Median follow-up was 38.7 months (m). 48 (48.5%) were alive at the cut-off date. Median age at diagnosis was 65 (32-86). 72.7% were men. 86.9% had squamous cell carcinoma; 42.4% stage II and 49.5% III. Localization: thoracic (53.3%), abdominal (20.1%), cervical (15.2%) and EGJ (10.1%). General characteristics were well balanced between groups. RR after the CRT phase were similar (CP: 53.1%; CF: 55.5%; p = 0.198). Median DFS was 23.2m (95%CI 5.9-not reached) and 7.2m (95%CI 4.9-9.4) for CF and CP, respectively (HR 0.55; 95%CI 0.29-1.56; p = 0.08). In the multivariate analysis CF was an independent prognostic factor for improved OS (HR 0.36; 95%CI 0.15-0.91; p = 0.03), as were higher body mass index (p = 0.03) and staging (p = 0.04). Rates of major toxicities were similar between the groups.
Conclusions
CRT followed by consolidation with CF seems to offer better outcomes than definitive CRT with CP for ES cancer pts not eligible for surgery. Consolidation therapy or type of chemotherapy may have contributed for this difference in outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3034 - Efficacy and safety of neoadjuvant chemotherapy plus trastuzumab and pertuzumab in non-metastatic HER2-positive breast cancer in real life: NEOPEARL STUDY
Presenter: Maria Agnese Fabbri
Session: Poster Display session 2
Resources:
Abstract
4772 - Real world comparison of the impact of adjuvant capecitabine in women with high-risk triple-negative breast cancer after neoadjuvant chemotherapy
Presenter: Maysa Vilbert
Session: Poster Display session 2
Resources:
Abstract
5627 - Influence of age on the indication of adjuvant chemotherapy in early breast cancer using Oncotype DX. An analysis of 240 patients treated in the Institut Catala d’Oncologia (ICO) hospitals
Presenter: Sabela Recalde
Session: Poster Display session 2
Resources:
Abstract
3917 - Impact of delayed neoadjuvant systemic chemotherapy on survival among breast cancer patients
Presenter: Mariana Chavez Mac Gregor
Session: Poster Display session 2
Resources:
Abstract
2246 - Clinical Confirmation of Higher Exposure to Niraparib in Tumor vs Plasma in Patients With Breast Cancer
Presenter: Laura Spring
Session: Poster Display session 2
Resources:
Abstract
581 - The rationale for the effectiveness of systemic treatment of breast cancer depending on the body weight index
Presenter: Mohammad Hojouj
Session: Poster Display session 2
Resources:
Abstract
5327 - Response to neoadjuvant chemotherapy in HER2 non-overexpressing breast cancer subtypes
Presenter: Silvia Mihaela Ilie
Session: Poster Display session 2
Resources:
Abstract
3613 - Pre-specified interim analysis of the SAFE trial (NCT2236806): a 4-arm randomized, double-blind, controlled study evaluating the efficacy and safety of cardiotoxicity prevention in non-metastatic breast cancer patients treated with anthracyclines with or without trastuzumab.
Presenter: Lorenzo Livi
Session: Poster Display session 2
Resources:
Abstract
3736 - Safety of hypofractionated whole breast irradiation after conservative surgery for patients aged less than 60 years: a multi-center comparative study.
Presenter: Icro Meattini
Session: Poster Display session 2
Resources:
Abstract
5085 - Usefulness of NT-ProBNP as a biomarker of cardiotoxicity in breast cancer patients treated with trastuzumab
Presenter: Isabel Blancas López-Barajas
Session: Poster Display session 2
Resources:
Abstract