Abstract 1245P
Background
In locally advanced oesophageal cancer, neoadjuvant chemo-radiotherapy improves survival compared with surgery alone. In the Chemo-Radiotherapy for Oesophageal cancer followed by Surgery Study (CROSS), the median age was 60. However, 1/3 of patients diagnosed with oesophageal cancer are over 70 years. The CROSS outcomes are therefore limited in its application to older patients. Our objective was to report the outcomes and tolerability in elderly patients (≥70 years), who underwent neoadjuvant chemo-radiation for oesophageal cancer compared with those < 70 years.
Methods
We performed a retrospective review of patients treated with neoadjuvant chemo-radiation for oesophageal cancer between 1st January 2015 and 1st January 2021. Baseline characteristics and haematological toxicities were reported. Pathological response was reported. Survival was estimated using the Kaplan-Meier method.
Results
In total 105 patients were included; 35 (33%) were ≥ 70 years and 70 (67%) patients were < 70 years. In the elderly cohort, the median age was 75 (70-86) and the younger cohort median age was 60 (29-69). 73% of patients in each cohort were male. 31 (89%) of older adults experienced any grade of anaemia compared with 45 (64%) of the younger cohort. Only one patient experienced ≥ grade 3 anaemia in each cohort. 18(51%) and 33(47%) of older and younger patients respectively experienced any grade of neutropenia. 5(14%) older and 7(10%) younger patients experienced ≥ grade 3 neutropenia. 15(43%) and 43(61%) of older and younger patients experienced any grade of thrombocytopenia. No patients experienced ≥ grade 3 thrombocytopenia. 80% of the older and 86% of the younger cohort proceeded to surgery. 3(11%) and 17(29%) of the older and younger cohorts respectively who underwent surgery achieved a complete pathological response. There was no difference in overall survival between the cohorts (p=0.48).
Conclusions
In conclusion, we confirm that neoadjuvant chemo-radiation is tolerable in patients ≥ 70 when compared with patients < 70 years. Overall survival is similar in both cohorts. We recommend the use of neoadjuvant therapy in appropriately selected patients ≥ 70 years of age.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
J. Naidoo: Financial Interests, Personal, Advisory Board: Merck, AstraZeneca, Roche/Genentech, Bristol-Myers Squibb, Takeda, Pfizer; Financial Interests, Personal, Other, independent adjudication of adverse events: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: AstraZeneca, Merck; Financial Interests, Institutional, Invited Speaker: Mirati. All other authors have declared no conflicts of interest.