689 / 1096
S673
ESTRO 36
_______________________________________________________________________________________________
failure in terms of local control (LC) and metastasis-free
survival (DMFS).
Material and Methods
We performed a multicenter retrospective study and we
selected for this analysis 67 pts Antigen Lewis positive
(prCA19.9 > 5U/ml), judged to be secretors of CA19.9. We
used the Kaplan-Meier method and the log-rank test to
investigate differences in LC and DMFS between groups
defined based on clinical and pathological factors,
different poCA 19.9 cutoff (37, 100 U/mL), paCA 19.9
cutoff (37 U/mL), and differences (%) between prCA19.9
and poCA19.9 levels.
Results
Demographic data and results are shown in Table 1.
Median follow-up (FU) was 18 months (2-225). At
univariate analysis, levels of poCA19.9 >37 U/ml (p=
0.009) or >100 (p< 0.001) and levels of paCA19.9 >37 U/ml
(p= 0.009) were significantly associated with a worse
DMFS. A change in prCA19.9 to poCA19.9 did not impact
LC and DMFS. CRT did not impact pattern of failure in the
whole patients population. Only in patients with poCA19.9
> 37 U/ml CRT significantly affected LC (63.6% for patients
treated with CRT vs 40.0% for patients not treated with
CRT;
p =
0.008).
Conclusion
Monitoring CA19.9 seems a useful parameter to modulate
the management of PAC patients in terms of choice of
adjuvant treatment and follow-up intensity.
EP-1251 Safety and Efficacy of Preoperative
Chemoradiotherapy in Patients with Locally Advanced
EGJ Cancer
Y. Li
1
, X. Li
1
, Y. Zhang
1
, J. Geng
1
, Y. Cai
1
, Z. Li
2
, K. Hu
3
,
J. Yu
4
, J. Jin
5
, D. Zhao
6
, B. Qu
7
, L. Chen
8
, J. JI
2
1
Key laboratory of Carcinogenesis and Translational
Research Ministry of Educati Peking University Cancer
Hospital & Institute, Department of Radiation Oncology,
Beijing, China
2
Key laboratory of Carcinogenesis and Translational
Research Ministry of Educati Peking University Cancer
Hospital & Institute, Gastrointestinal Cancer Center,
Beijing, China
3
Peking Union Medical College Hospital-Chinese Academy
of Medical Sciences and Peking Union Medical College,
Department of Radiation Oncology, Beijing, China
4
Peking Union Medical College Hospital-Chinese Academy
of Medical Sciences and Peking Union Medical College,
Department of General Surgery, Beijing, China
5
Cancer Hospital-Chinese Academy of Medical Sciences,
Department of Radiation Oncology, Beijing, China
6
Cancer Hospital-Chinese Academy of Medical Sciences,
Department of Pancrea-gastric Surgery, Beijing, China
7
Chinese People's Liberation Army General Hospital,
Department of Radiation Oncology, Beijing, China
8
Chinese People's Liberation Army General Hospital,
Department of General Surgery, Beijing, China
Purpose or Objective
To evaluate the safety and efficacy of preoperative
chemoradiotherapy and D2 radical resection in patients
with locally advanced gastroesophageal junction
carcinoma
Material and Methods
Gastroesophageal
junction
carcinomapatients
withadenocarcinoma, clinical stage T3-4N0 or any TN1-
3M0, Siewert type II and III were enrolled. After exclusion
of peritoneal metastasis with laparoscopic exploration,
patients were randomly assigned into surgery group and
preoperative chemoradiotherapy plus surgery group. The
preoperative chemoradiotherapy group received intensity
modulated radiation therapy (IMRT) and concurrent
chemotherapyS-1 combined with oxaliplatin weekly plan.
The prescription dose was GTV 50Gy/CTV 45Gy/25f/35d
with concomitant boost. For the concurrent
chemotherapy, S-1 was 30mg/m2 bid, five days a week;
oxaliplatin was 40mg/m2 per week, with a total of 5
weeks.Laparoscopic exploration was needed 6 weeks after
the end of the preoperative chemoradiotherapy. Patients
with no peritoneal metastasis underwent D2 radical
resection.Postoperative
patients
received
SOX
chemotherapy for 6-8 cycles. This trial (PAPER) is a
multicenter randomized controlled studyin Beijing,
Tianjin and Hebei Province. Primary endpoint is 3-year
DFS, the secondary endpointsare safety and effectivity
Results
From Sep. 2014 to Jul. 2016,40 cases of 4 centers were
enrolled. There were 20 patients in surgery group and 15
cases in the preoperative chemoradiotherapy group. The
median age was 61 years (range 33-73).28 were male and
7 were female. Clinical staging were as follows: 20 cT3,
15 cT4; 4 cN0, 8 cN1, 19 cN2, 13 cN3. In the preoperative
chemoradiotherapy group ,All patients completed
radiotherapy. Six patients cannot tolerate concurrent
chemotherapy due to toxicity.There was no grade 4
toxicity.The incidence of grade 3 toxicities were 13.3%:
neutropenia. The incidence of grade 2 toxicities were 80%,
including: thrombocytopenia (26.7%), neutropenia (6.7%)
,esophagitis and nausea(13.3%). All patients underwent
radical D2 resection. Pathological complete response
occurred in 13.3% (2/15) of patients. The T and N
downstaging rate were 86.7% (13/15) and 100% (11/11).
respectively.
The tumor regression grade (TRG) were1 case of Grade 0,
2cases of Grade 1 and 3 cases of Grade 2, respectively.
Surgery-related complications consisted of anastomotic
leakage in 2 (13.3%), infection in 1 (6.7%) and hemorrhage
in 1 (6.7%) patients. The perioperative mortality was nil.
In the surgery group, Surgery-related complications
consisted of anastomotic leakage in1 (6.7%), infection in 1
(6.7%) and hemorrhage in 1 (6.7%) patients. The
perioperative mortality was nil
Postoperative complications had no significant differences
between two groups
Conclusion
Preoperative Chemoradiotherapy for patients with locally
advanced gastroesophageal junction adenocarcinoma
showed an acceptable toxicity, promising efficacy and
safety for D2 resection. Further conclusions need to be
verified by the mid-term results after the completion of