Abstract 400P
Background
Esophageal cancer is the seventh cause of cancer-related mortality worldwide. Its incidence is much higher in some part of the world, including north of Iran. Over the past decades, the treatment of this disease has been changed from exclusive surgery to multimodality therapy. Currently, the preferred treatment of resectable locally advanced esophageal cancer includes neoadjuvant chemoradiotherapy (CRT), followed by surgical resection. The aim of this study was to compare the pathologic response to neoadjuvant CRT with oxaliplatin and capecitabine (XELOX), as well as carboplatin and paclitaxel (CP) regimens, based on the tumor regression grade.
Methods
This is a randomized phase II trial, which was performed on a total of 59 patients with esophageal cancer at Cancer Institute of Imam Khomeini hospital in Tehran, Iran, between 2016 to 2017. The eligible patients were randomly assigned to two groups, including A) the cases with CP regimen concomitant with radiotherapy (n=33) and B) the subjects with XELOX regimen concurrent with radiotherapy (n=26). The surgery was performed in 4 to 8 weeks after CRT. The primary endpoint of the study was the pathologic complete response and the secondary endpoints included toxicity and surgical mortality.
Results
In the present study, 17 patients (51.51%) in the CP group and 19 cases (73.08%) in the XELOX group underwent the surgery (P=0.113). There was no significant difference between the two groups regarding the mortality rate of CRT; however, the changes in blood indices, including leukopenia, lymphocytopenia, and neutrophil count, were significantly higher in the CP arm than in the XELOX arm. The percentages of complete response were reported as 41% and 39% in the CP and XELOX groups, respectively.
Conclusions
Overall, the results of this study indicated that none of these two regimens was superior to the other one in terms of tumor response rates. However, the level of toxicity was lower in XELOX group, compared to that in the CP group.
Clinical trial identification
IRCT20140903019036N3.
Legal entity responsible for the study
Ebrahim Esmati.
Funding
Tehran University of Medical Sciences.
Disclosure
All authors have declared no conflicts of interest.