ESMO 2019 Congress | OncologyPRO

Abstract 2860

Background

Although, previous studies reported that metabolic response (MR) assessed by post-CRT ¹⁸FDG-PET was associated with survival outcomes in ESCC treated with dCRT, there are few data on the prognostic value of each metabolic response category after induction chemotherapy prior to dCRT and after completion of dCRT.

Methods

In this retrospective study, we evaluated prognostic value of MR after completion of induction chemotherapy and after completion of dCRT in 382 localized ESCC pts receiving induction chemotherapy followed by dCRT from January 2012 to February 2018 at Asan Medical Center in Korea. MR was assessed by EORTC criteria.

Results

MR after induction chemotherapy was significantly associated with progression-free survival (PFS) and overall survival (OS). MR after dCRT was also significantly associated with PFS and OS. MR after either induction chemotherapy or dCRT remained significant after adjusting for other prognostic factors such as clinical TNM stage, sex, and ECOG performance status. Whereas pts achieving mCR/mPR or mPD after either induction chemotherapy or dCRT had good prognosis or poor prognosis, respectively, the prognostic value of mSD was different between post-induction chemotherapy and post-dCRT; it was similar to that of mPR after induction chemotherapy, but it was similar to that of mPD after dCRT. Poorer MR to induction chemotherapy could predict the lack of MR after dCRT; the proportion of mSD/mPD after dCRT was 7.7% in pts with post-induction mCR vs. 16.0% in pts with vs. 40.0% in pts with post-induction mSD vs. 100% in pts with post-induction mPD (p = 0.001).Table:

762P

	Post induction chemotherapy	Post-dCRT
metabolic response	N	HR for PFS (95% CI)	P-value	HR for OS (95% CI)	P-value	N	HR for PFS (95% CI)	P-value	HR for OS (95% CI)	P-value
mCR	13	1		1		150	1		1
mPR	106	3.348 (1.221-9.181)	0.019	2.498 (1.008 - 6.192)	0.048	164	2.182 (1.646-2.892)	0.000	2.224 (1.694-2.919)	0.000
mSD	10	6.008 (1.179-20.150)	0.004	3.640 (1.186-11.171)	0.024	7	11.251 (5.088-24.878)	0.000	9.659 (4.393-21.236)	0.000
mPD	2	59.209 (9.430-371.767)	0.000	14.495 (2.676-78.503)	0.002	39	21.768 (14.020-33.797)	0.000	10.592 (7.016-15.989)	0.000
diffuse esophagitis	3	1.729 (0.193-15.482)	0.624	1.103 (0.129-9.453)	0.929	22	1.169 (0.651-2.098)	0.601	1.482 (0.856-2.566)	0.160
Total	134		0.000		0.027	382		0.000		0.000

Conclusions

MR after induction chemotherapy and after CRT had independent prognostic value with different prognostication between each other in ESCC pts receiving induction chemotherapy followed by dCRT.

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

29 Sep 2019