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
733 - Clinical experience: ramucirumab with FOLFIRI/XELIRI as a second line for patients with metastatic gastric cancer
Presenter: Tatiana Titova
Session: Poster Display session 2
Resources:
Abstract
2186 - Efficacy and safety of apatinib for the treatment of AFP-producing gastric cancer
Presenter: Ningning Li
Session: Poster Display session 2
Resources:
Abstract
3172 - Apatinib in combination with docetaxol and S1 chemotherapy in the first line treatment of metastatic gastric cancer
Presenter: Ling Xia
Session: Poster Display session 2
Resources:
Abstract
3982 - Parameters of local cellular immunity in metastatic gastric cancer
Presenter: Aleksandr Sagakyants
Session: Poster Display session 2
Resources:
Abstract
5102 - Germline pathogenic mutations in Chinese patients with gastric cancer identified by next-generation sequencing (NGS)
Presenter: Xiaotian Zhang
Session: Poster Display session 2
Resources:
Abstract
5012 - Inhibition of the PI3K pathway in HER2-positive gastric cancer
Presenter: Sinead Toomey
Session: Poster Display session 2
Resources:
Abstract
4803 - Investigation on gastric cancer susceptibility genes in Chinese early-onset diffuse gastric cancer
Presenter: Yi Feng
Session: Poster Display session 2
Resources:
Abstract
4778 - A correlation analysis between survival rate and the characteristic gene of gastric cancer based on bioinformatics analysis
Presenter: Yi-wen Zhang
Session: Poster Display session 2
Resources:
Abstract
4805 - Phase I study of apatinib combined with POF (paclitaxel plus FOLFOX) in patients (pts) with treatment-naïve advanced gastric cancer (TNAGC)
Presenter: Rongbo LIN
Session: Poster Display session 2
Resources:
Abstract
3248 - Second-line palliative systemic treatment for synchronous metastatic esophagogastric cancer: a population-based study
Presenter: Willemieke Dijksterhuis
Session: Poster Display session 2
Resources:
Abstract