P0039 Preoperative combined chemoradiotherapy for oesophageal or junctional cancers: 10-Year review

Abstract

<h3>Background</h3> The purpose of this study was to analyse treatment outcome in patients with oesophageal and junctional cancers treated at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. <h3>Methods</h3> We retrospectively reviewed 283 patients treated with curative intent between January, 2002, and October, 2012. Median age was 55years (range 18–82years). 56% were men and 44% were women. 78% of the patients had squamous cell carcinoma, 22% had adenocarcinoma, and 1% had small cell histology. 56% of the patients had lower thoracic tumours, 20% had middle thoracic tumours, 18% had junction cancers. Clinical stages at presentation were stage IB (5% of patients), IIA (2%), IIB (34%), IIIA (35%), IIIB (2%), and IIIC (2%). Of 283 patients, 216 had induction chemotherapy. Cisplatin/fluorouracil was the most common regimen used (81%). Concurrent chemoradiotherapy was given to 263 patients, and 12 patients had radiotherapy alone. 135 patients had surgery. 77% of patients had transhiatal oesophagectomy. <h3>Findings</h3> Following induction chemotherapy, 5% of patients had grade III toxicities (nausea/vomiting and neutropenia). Concurrent chemoradiotherapy was well tolerated. The 5-year overall survival (OS) and progression free survival (PFS) of the whole group were 38% and 30%, respectively. In patients who underwent surgery, the 5-year OS and PFS were 43% and 38%, respectively. In patients who did not undergo surgery, the 5-year OS and PFS were 33% and 15%, respectively. Pathological complete response was seen in 36% of patients. Pathological complete response with cisplatin/fluorouracil regimen was seen in 40% of patients. Recurrence was seen in 25% of patients, of which 62% failed distantly. <h3>Interpretation</h3> Preoperative chemoradiotherapy followed by surgery improved survival among patients with potentially curable oesophageal or junctional cancers.