ESTRO 2022

Session Item

Upper GI

Session Code: 6010

Session Type: Poster (digital)

Track: Clinical

Neoadjuvant chemoradiotherapy for esophageal cancer – a single institution experience

Ajra Secerov Ermenc, Slovenia

Presentation Number: PO-1297

Abstract

Abstract Title:

Neoadjuvant chemoradiotherapy for esophageal cancer – a single institution experience

Authors:

Ajra Secerov Ermenc¹, Frane Anderluh¹, Ana Jeromen Peressutti¹, Vaneja Velenik¹, Irena Oblak¹, Peter Korosec¹, Jasna But Hadzic¹, Natasa Pulko²

¹Institute of Oncology, Division of Radiotherapy, Ljubljana, Slovenia; ²University Medical Centre Maribor, Department of Oncology, Maribor, Slovenia

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Purpose or Objective

Neoadjuvant chemoradiotherapy (nCRT) followed by surgery is the standard care for locally advanced esophageal carcinoma of the lower two thirds of esophagus. The purpose of the study was to evaluate treatment outcome regarding the concomitant chemotherapy regimen and stent placement in a single institution.

Material and Methods

We retrospectively analyzed the data from patients with esophageal cancer who were treated with IMRT at our institution from July 2013 to May 2021. We included patients with locally advanced esophageal cancer. They received IMRT with the dose of 45 Gy in 25 fractions. From July 2013 to May 2019 the standard regimen of concomitant chemotherapy was 5-FU/cisplatin, after May 2019 it was paclitaxel/carboplatin.

Results

One-hundred-two patients were available for analysis. Median age at diagnosis was 63 years, 81% patients were men and 59% had squamous cell carcinoma. Paclitaxel/carboplatin (PC) as concomitant chemotherapy was administered to 33 patients (32.4%) and 5-FU/cisplatin (FC) to 69 patients (67.6%). Surgical resection was achieved in 28 patients (84.8%) in the PC group and in 45 (69.2%) patients in the FC group, (p=0.09). Complete pathological response was observed in 11 patients (39.3%) in the PC group and in 9 patients (21.4%) FC group, (p=0.10). There was no difference in two-year OS, for both groups it was 35%, (p=0.05). Hospitalisation due to complication of nCRT treatment was observed in 33% in the PC and 42% in the FC group, (p=0.45).

Stents were placed in 13 (11%) patients in order to relieve dysphagia prior nCRT. Surgical resection was achieved in just 3 (23%) patients with stent placement in comparison to 70 (84%) patients without stent placement, (p=0.00). Median OS for patients with stent was 7 months and for patients without stent 30 months, (p=0.00).

Conclusion

We did not observe differences in treatment outcome between two groups of concomitant chemotherapy, only a trend in favour of patients that were treated with nCRT with concomitant paclitaxel and carboplatin. Patients with stents placed prior nCRT had worse overall survival.