PS02.121: INTENSIFIED IMRTWITH CARBOPLATIN AND PACLITAXEL IN LOCALLY ADVANCED ESOPHAGEAL CANCER: AN ANALYSIS ON EARLY OUTCOME

Abstract

Abstract Background Evaluate safety, feasibility and efficacy of an intesified IMRT and concomitant carboplatin and paclitaxel-based chemotherapy (Carbo/Tax CT) in patients (pts) with locally advanced esophageal cancer (LAEC) treated at our Institution Methods We retrospectively analyzed acute toxicity (according to CTCAE 4.0 scale), compliance and response to treatment in a series of consecutive patients treated, between February 2016 and February 2018, with intensified radiotherapy (IMRT) and weekly concurrent carboplatin and paclitaxel-based chemotherapy (CT) according to the CROSS trial. Results Thirty-four consecutive pts, 30(88%) males and 4 (12%) females, were treated. The median age was 68.5 yrs (range 46–83) and the ECOG Performance status ranged from 0 to 2. The diagnosis was adenocarcinoma in 15 pts (44%), squamous-cell carcinoma in 18 pts (53%) and undifferentiated carcinoma in 1 pt (3%). Two pts (6%) had a T2, 26 pts (76.4%) a T3 and 6 pts (17.6%) a T4 disease, respectively; 5 pts (15%) were N0, 21 pts (62%) N1 and 8 pts (23%) N2, respectively. Tumor involved the cervical esophagus in 3 pts (9%), the thoracic esophagus in 24 pts (70.5%) and the gastroesophageal junction in 7(20.5%). All pts underwent concurrent chemoradiotherapy (CRT), with IMRT technique, consisting of 45 Gy/25 frs to PTV1 (the primary gross tumor volume and the regional nodes), a simultaneous integrated boost ranging from 52.5Gy to 54Gy to PTV2 (gross tumor volume) and weekly concurrent carboplatin (AUC2) and paclitaxel (50mg/m2). Induction CT was administered to 6 pts. All pts completed the RT schedule. The median number of CT cycles was 3 (range 1–5) and 11 pts (32%) received 4 to 5 cycles of CT. Two adverse reactions to paclitaxel were reported. There were no major non-hematological adverse effects, the most common were nausea and vomiting (10%), and dysphagia (7%). Leukopenia was reported in 20 pts (71%), G3 in 2 pts (10%) and G2 in 18 (90%), respectively. G2 anemia occurred in 2 pts while G2 thrombocytopenia was reported in 3 pts (10%). Among the 30 evaluable pts (restaging is ongoing in 4 pts) a clinical complete response (PET, endoscopy and biopsy) was observed in 11 pts (37%), 7 with adenocarcinom and 4 with squamous cell carcinoma. Partial response was observed in 11 pts (37%) and 8 (26%) showed progressive disease. Total esophagectomy with radical lymphadenectomy, performed in 11 pts, showed a pathologic complete response in 6 pts (54%). Conclusion Intensified IMRT with concomitant Carbo/Tax CT in pts with LAEC seems to be safe and effective. These promising results need to be confirmed in all pts evaluated in this multimodality program Disclosure All authors have declared no conflicts of interest.