603. NEOADJUVANT DCF VERSUS CRT IN COMPLEX TREATMENT OF LOCALLY ADVANCED ESOPHAGEAL SQUAMOUS CELL CANCER

Abstract

Abstract Both neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy improve tumor resectability, lead to downstaging of tumor process and increase overall and disease-free survival rates. This study investigates the efficacy and outcomes after neoadjuvant chemotherapy with DCF regimen and chemoradiotherapy for patients with locally advanced esophageal squamous cell carcinoma. We retrospectively analyzed the results of 130 patients from 2013 to 2018 who received preoperative DCF chemotherapy (docetaxel 70 mg/m2 on day 1, cisplatin 70 mg/m2 on day1, 5-FU 750 mg/m2 on days 1-5, total 4 courses) followed by surgery or chemoradiotherapy (paclitaxel 175 mg/m2 on day 1, cisplatin 75 mg/m2 on day 1, 5-FU 750 mg/m2 on days 1-5 and 46 Gy) followed by surgery. Surgery included both open and minimal invasive esophagectomy with regional lymphadenectomy. Data, surgical results, treatment related complications and long-term results were compared in two groups. Patient characteristics did not differ between the two groups. Incidence of > grade 2 complications were higher in the DCF group. Incidence of neutropenia was in 72.3% versus 30.7% in the CRT group, febrile neutropenia 18.4% and 7.7%, respectively. The R0 resections were similar (98.3%). Chylothorax was noted only in two patients in the CRT group (3.0%). Complete pathological response in the CRT group was in 35.3% versus 20.0% in the DCF group. 3-year overall survival in the DCF and CRT groups was 70.7% and 64.6%, and 3-year disease-free survival was 60.0% and 49.2%, respectively (p<0,05). Thus, 4 courses of DCF is not inferior compared to CRT in terms of survival rates and becomes an alternative to CRT in the complex treatment of locally advanced squamous cell carcinoma of the esophagus.