ESTRO 36 Abstract Book

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S671 ESTRO 36
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did not complete dCRT because of comorbidity or toxicity.
Median follow up was 56 months. Median OS was 21 months
and not significantly different between patients with SCC
(20 [95% CI 15-25] months; n=73), AC-I (24 [95% CI 21-27]
months; n=34) or AC-D+M (15 [95% CI 7-23] months; n=10).
Median DFS was 19 months and, for SCC, AC-I and AC-D+M,
DFS was 18 (95% CI 10-30), 21 (95% CI 21-27) and 15 (95%
CI 7-23) months, respectively (p=0.29). Median time to
isolated LRR was 64 months; for SCC, AC-I and AC-D+M,
this was 64 (95% CI 0-129), 47 (95% CI 1-93) and 18 (95% CI
5-31) months, respectively (p=0.61). Multivariable analysis
was adjusted for gender, age, completion of radiotherapy
(all significantly associated with prognosis in univariable
analysis), chemotherapy regimen and Charlson
comorbidity score (both p=0.1 in univariable
analysis). Age and failure to complete radiotherapy were
significant predictors for overall survival. As compared to
SCC, overall survival was similar for AC-I; HR 1.22 (95% CI
0.72-2.1) and AC-D+M; HR 1.93 (95% CI 0.9-4.0).
Conclusion
In our cohort no significant relationship was found
between the histological subtype and long-term outcomes
following dCRT for esophageal cancer, although, AC-D+M
showed a trend towards poorer outcomes. Not only for
SCC, but also for intestinal type adenocarcinomas of the
esophagus, dCRT can be considered.
EP-1247 Exclusive chemoradiation with Carboplatin-
Taxol vs Folfox-4 in locally advanced esophageal
cancer.
G. Crehange1, A. Bertaut2, J.F. Bosset3, J. Boustani 3, M.
Rouffiac1 , F. Ghiringhelli4, C. Borg5, B. De Bari3, J. Buffet
Miny3
1 Centre Georges-François Leclerc, Radiotherapy, Dijon,
France
2 Centre Georges-François Leclerc, Biostatistics, Dijon,
France
3 University Hospital Jean Minjoz, Radiation Oncology,
Besançon, France
4 Centre Georges-François Leclerc, Medical oncology,
Dijon, France
5 University Hospital Jean Minjoz, Medical Oncology,
Besançon, France
Purpose or Objective
Exclusive chemoradiation delivering 50Gy of external
beam radiotherapy (EBRT) combined with Cisplatinum and
5-FU remains the standard of care for locally advanced
disease since a quarter century. The French PRODIGE 5
phase III trial has demonstrated the safety and the efficacy
of FOLFOX-4 combined with exclusive 50Gy EBRT while the
Dutch CROSS phase III trial showed an improvement in
overall survival with Carboplatin and Taxol when
combined with 41.4Gy in the preoperative setting. We
sought to determine the feasibility and efficacy of
exclusive EBRT with Carboplatin-Taxol compared to
FOLFOX-4 regimen.
Material and Methods
Patients were matched 1:1 with respect to age at
diagnosis (±5 years), stage (I-II vs III-IV), biopsy proven
histology (squamous vs adeno) and topography (upper,
middle or lower third or cardia). 46 patients followed the
above criteria and remained for the final analysis : 23
patients were treated with FOLFOX-4 regimen (group A)
and 23 patients with Carboplatin AUC2 mg/mL per min and
Taxol 50mg/m2, weekly (group B). Comparison between
the 2 groups was performed using Mac Nemar test for
paired data. Statistical analyses were performed using SAS
9.3 software. All tests were two sided and P values were
considered significant when less than 0.05.
Results
The mean age in group A was 69.4 years (12.5) and 72.4
years (12.6) in group B (p=ns). In each group, 11 patients
had a stage III disease at diagnosis (47.8%) with only 2
stage IV in group A (8.7%) vs none in group B.
The median delivered RT doses were 50Gy [14-60] in group
A while it was 50Gy [20-70] in group B. We found no
difference in the compliance with chemotherapy in each
group : 6 courses were delivered in 12 patients in group A
(52.2%) and 14 patients in group B (60.9%) (p=0.51). No
difference in dose reduction was observed between each
group for each course of chemotherapy.
After chemoradiation, G1 or higher esophagitis was
observed in 5 patients (26.3%) in group A and 3 patients
(13.0%) in group B of whom 0 vs 2 G3 were observed in
group A and B, respectively. Four patients (21.1%) had a
pulmonary infection in group A and 3 in group B (13.0%).
Looking at haematological toxicity, 2 patients (8.7%) vs 4
patients (17.4%) had G3 neutropenia, with only 0 and 2
neutropenic fever in group A and B, respectively. No
patient had G-CSF. Neither G3 anemia, nor G3
thrombopenia occured.
After a median follow-up of 17.7 months [0.0-46.9], 25
patients had died, 14 in group A (60.9%) and 11 in group B
(47.8%).
The median PFS rates were 14 months in group A [7.7-NR]
vs 12.1 months [4.4-NR] in group B (p=0.32).
The median OS rates were 20.3 months in group A [6.2-
39.3] vs 17.0 months [4.8-NR] in group B (p=0.82).
Conclusion
Exclusive chemoradiation with Carboplatin and Taxol
seems feasible with similar toxicity and survival outcomes
than FOLFOX-4. The safety and efficacy of the CROSS
regimen needs to be tested prospectively with EBRT doses
>41.4Gy in a phase II or III trial.
EP-1248 Adjuvant radiotherapy for gastric cancer
patients underwent gastrectomy and D2 lymph node
dissection
Y. Wang1, J.M. Hwang1, Y.K. Chang 1, W.Y. Kao2, H.L.
Wan2, S.Y. Chang2, C.C. Wu3
1Taipei Tzu Chi Hospital, Radiation Oncology, New Taipei
City, Taiwan
2Taipei Tzu Chi Hospital, Medical Oncology, New Taipei
City, Taiwan
3Taipei Tzu Chi Hospital, General Surgery, New Taipei
City, Taiwan
Purpose or Objective
The benefit of adjuvant chemoradiation (CRT) has been
confirmed by the Intergroup 0116 (INT-0116) study.
However, as D2 lymph node dissection has been linked to
lower recurrence rate, the role of adjuvant radiotherapy
(RT), whether with or without concurrent chemotherapy,
following D2 dissection is controversial. The goal of this
study is to review the clinical outcome of patients with
locally advanced gastric adenocarcinoma underwent
gastrectomy and D2 lymph node dissection with or without
adjuvant RT.
Material and Methods
We reviewed 420 patients who were diagnosed with
gastric cancer at Taipei TzuChi Hospital during Jan, 2008
to Sep, 2015, while excluding the following patients: those
a) >80 years old, b) didn’t undergo gastrectomy and D2
dissection, c) with distant metastases at diagnosis, d)
stage IA or IB without nodal metastases, or e) patients who
had never been disease-free. The overall survival (OS) and
disease-free survival (DFS) rates were compared between
patients treated with or without adjuvant RT. Chi-square
test or unpaired t-test were used to compare the age,
gender, positive lymph nodes (LN) numbers, stage, and
chemotherapy status distribution between these two
groups.
Results
Of those selected patients, thirty-one underwent adjuvant
RT and 40 didn’t. The characteristics were described in