Abstract 1441P
Background
Trimodality therapy using the CROSS trial protocol is an accepted standard of care for locally advanced EC and GEJC. For medically inoperable patients, CRT is standard. This single institution review aims to assess the real world application of the CROSS trial protocol.
Methods
A retrospective review was undertaken of 83 patients who underwent CRT with carboplatin and paclitaxel with trimodaility or upfront definitive intent between June 2012 and June 2018. Patients’ demographics, clinical, pathological, treatment and surgical characteristics were assessed. These factors and outcomes were analyzed in exploratory analyses.
Results
Of the 83 patients, 65 underwent nCRT; 40 had surgery and 18 received dCRT. For the 83 patients, median age was 69 yrs (range 48-82), 80% were male, 77% adenocarcinoma, median tumor length was 5 cm, and 80% were Siewert I. The median RT dose was 50.4 Gy, median chemotherapy doses were 5, median time from diagnosis to CRT was 69 days and median time from CRT to surgery was 62 days. For patients ≥ 75 yrs, based on surgical eligibility, 5 (23%) had nCRT and 13 (72%) had dCRT; of these 49% and 33% respectively had no interruptions to CRT. Patients who underwent surgery were younger (p = 0.04) and weighed more (p = 0.05). For nCRT and surgery, nCRT only, and dCRT respectively, the median overall survival was 35.5, 12.1 and 17.1 months (log rank p=0.008), progression free survival was 32.2, 10 and 9.6 months (log rank p=0.001). Further correlative outcome data will be presented.
Conclusions
Although there was a broadening of the CROSS trial eligibility criteria in our real world data, survival benefit is maintained with trimodality therapy. The use of carboplatin and paclitaxel in dCRT needs to be further evaluated especially given the therapeutic potential of this modality in the elderly.
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.