Safety and Efficacy of Concurrent Chemoradiotherapy for Advanced Esophagogastric Junction Squamous Cell Carcinoma

Safety and Efficacy of Concurrent Chemoradiotherapy for Advanced Esophagogastric Junction Squamous Cell Carcinoma

Annals of Oncology 25 (Supplement 5): v75–v109, 2014 doi:10.1093/annonc/mdu436.79 Poster Session (Poster presentations categorized by each organ) P2 ...

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Annals of Oncology 25 (Supplement 5): v75–v109, 2014 doi:10.1093/annonc/mdu436.79

Poster Session (Poster presentations categorized by each organ) P2

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Kiyomi Sumita1, Takahiro Tsushima2, Satoshi Hamauchi2, Akiko Todaka2, Tomoya Yokota2, Nozomu Machida2, Kentaro Yamazaki2, Akira Fukutomi2, Yusuke Onozawa3, Hirofumi Yasui3 1 Division of Radiation Oncology, Shizuoka Cancer Center 2 Division of Gastrointestinal Oncology, Shizuoka Cancer Center 3 Division of Clinical oncology, Shizuoka Cancer Center

abstracts

Background: Esophagogastric junction (EGJ) cancer accounts for 4.2% of all esophageal cancer in Japan, and the outcome of chemoradiotherapy (CRT) for the disease is unclear. Objective: To assess the safety and efficacy of CRT for advanced EGJ squamous cell carcinoma (SCC).

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SAFETY AND EFFICACY OF CONCURRENT CHEMORADIOTHERAPY FOR ADVANCED ESOPHAGOGASTRIC JUNCTION SQUAMOUS CELL CARCINOMA

Methods: We retrospectively analyzed patients who were treated with definitive CRT for EGJ cancer between September 2002 and September 2013. Patient selection criteria were: pathologically confirmed SCC; clinical Stage IB-III excluding T4 disease (UICC 7th); ECOG performance status (PS), 0-2; preserved organ functions; no previous chemotherapy or radiotherapy; concurrent CRT with 5-FU + platinum and radiation therapy at least 50.0Gy. Results: Nine patients were identified out of 818 who received CRT for esophageal cancer. Patients’ background was: Male, 6; the median age, 67 years (range 56-78). PS 0/1/2, 7/1/1. Siewert types I/II/III, 6/3/0; Stage IB/IIA/IIIA/IIIB/IIIC (UICC 7th), 2/2/ 2/3/0; T 1/2/3, 0/2/7; N 0/1/2/3, 4/2/3/0. As concurrent chemotherapy, 8 patients received CDDP + 5-FU, and 1 received CDGP + 5-FU. The median radiation dose was 60Gy (range 45-60). Eight patients received at least 50Gy of radiation therapy, and 6 patients received 2 cycles of chemotherapy (treatment completion rate was 56%). The reasons for treatment incompletion were: adverse events, 3; and patient’s refusal, 1. Complete response rate was 44% (4/9). Common grade 3 or more adverse events were leukopenia, thrombocytopenia, hyponatremia, and esophagitis (33%, in each). No treatment related death was observed. With median follow-up of 8.5 months, the median progression free survival was 9.2 months (95%CI: 5.0-10.5). Disease progressed in 7 patients: regrowth of persistent primary tumor, 2; lymph node recurrence in irradiated field, 1; distant metastasis, 4. Conclusion: It is suggested that CRT for SCC of EGJ associates with higher adverse events and poorer outcome than that for thoracic esophagus.

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