PS02.036: FAILURE PATTERNS AND LATE TOXICITIES OF CONCURRENT CHEMORADIOTHERAPY FOR CERVICAL ESOPHAGEAL SQUAMOUS CELL CARCINOMA: FROM A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Abstract Background From a prospective observational study, we aim to observe failure patterns and late toxicities of concurrent chemoradiotherapy (CCRT) among patients with cervical esophagus squamous cell carcinoma (CESCC). Methods All patients were pathologically confirmed with no distant metastasis. All the patients received CCRT followed by consolidate chemotherapy. Elective nodal irradiation was given and platinum-based doublet chemotherapeutic regimens were chosen for both concurrent chemotherapy and consolidate chemotherapy. All patients were followed up every 3 months in the first 2 years after CCRT and every 6 months thereafter. Re-examinations included cervical CT, chest CT, barium esophagram, abdominal CT or B ultrasound, esophagoscopy when necessary. Results Ninety-two patients were enrolled from March 2007 to July 2014. The median radiation dose was 60Gy (range: 50–63Gy). The median follow-up time was 34 months for all patients and 51.5 months for survival patients. Three-years and 5-year OS were 49.8% and 44.4% (the median OS: 36 ± 5.631months). Treatment failures occurred in 54 patients, including 30 cases (32.6%) with loco-regional failures alone (LF), 14 cases (15.2%) with distant metastasis alone, and 10 cases (10.9%) with both failures. Among the patients with LF, in-field recurrence occurred in 32 cases (80%, 32/40), out-field recurrence occurred in 8 cases (20%, 8/40). Among the 24 patients with distant metastasis, pulmonary metastasis occurred in 13 patients (54%, 13/24). Totally 52 patients were dead. Thirty-five patients died of LF, 11 patients died of distant metastasis, 2 patient died of unrelated diseases, and another four patients died of severe toxicities (4.3%), three of them died of esophageal fistula and another 1 patient died of laryngeal edema. The major late complication was esophageal symptom. There were 7 cases that had 3th grade strictures. Most of them could be relieved by continuous dilatation programme. Conclusion The efficacy of CCRT for CESCC was satisfactory. In-field LF is still the predominant failure pattern after CCRT for cervical esophageal SCC. Improving in-field local control and reducing distant metastasis may contribute to better efficacy. Disclosure All authors have declared no conflicts of interest.