Abstract 408P
Background
Concurrent chemoradiation (CRT) prior to esophagectomy is routinely given for patients (pts) with localized esophageal adenocarcinoma (EAC), but the best chemotherapy regimen has not been established. Since 2012, carboplatin + paclitaxel (CP) has been the most common regimen, but more recently, concurrent fluorouracil + oxaliplatin (FOLFOX) has been used. We sought to compare outcomes between CP and FOLFOX in pts undergoing neoadjuvant CRT for localized EAC.
Methods
We conducted a single-institution retrospective chart review of pts with localized EAC who received neoadjuvant CRT and esophagectomy between 2015-2022. We recorded demographic information, disease characteristics (stage, histologic grade), treatment modalities, survival and recurrence. The primary endpoint was overall survival (OS), and the secondary endpoints were recurrence-free survival (RFS) and pathologic complete response (pCR).
Results
170 pts were identified. Median age was 64 (range 38-81), 85% were male, 96% were White. 47% of tumors were Grade 3, 44% Grade 2, and 4% Grade 1. 20% of pts had clinical Stage II disease, 76% had Stage III, and 4% had Stage IVA. 150 pts (88%) received CP and 20 (11.7%) received FOLFOX. Median follow-up was 27 months (mo). Median OS was 43.1 mo (range 20.7-92.7) in pts who received CP and not reached in the FOLFOX group (range 23.3-NR) (p=N/A). OS rates at 1, 2, and 3 years were similar between CP and FOLFOX. FOLFOX was associated with lower recurrence, though did not reach significance (25% vs 48%, p=0.052); CP tumors were more commonly poorly differentiated, though not significant (49% vs 30%, p=0.26), no differences in stage. pCR rates were not different between CP vs FOLFOX (18.7% vs 10%, p=0.34).
Conclusions
Concurrent CRT with FOLFOX was associated with longer OS and lower recurrence rates, though not statistically significant. OS rates at 1, 2, and 3 years were the same between FOLFOX and CP. There was no difference in pCR between CP and FOLFOX. This retrospective analysis of patient outcomes does not suggest clear benefit between CP and FOLFOX when given concurrent with RT neoadjuvantly for EAC.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.