PV QA 1 - Poster Viewing Q&A 1
Purpose/Objective(s): Concurrent Chemoradiotherapy are the standard of care for advanced esophageal squamous cell carcinoma ESCC. No randomised trials have evaluate the survival and toxicity of adjuvant chemotherapy
Materials/Methods: In a prospective study, we analysed retrospectively patients with locally advanced ESCC, treated with concurrent chemoradiation with or without adjuvant chemotherapy in a single high-volume centre. Between 2011 and 2016, 103 patients with advanced (cT2-4N1-3M0) ESCC received treatment and were evaluated to participate radiomised to this trial NCT01551589 . 20 patients were excluded this study because 7，5 and 9 patients were M1，more than 75 years and abnormal liver function. 83 patients were included in this study. 40 and 43 patients underwent concurrent chemoradiotherapy without and with adjuvant chemotherapy. using the modified Time-to-Event Continual Reassessment Method (TITE-CRM) chemotherapy cycles escalation with toxicity. Toxicity was graded according to CTCAE Version 3.0.
Results: The two groups were comparable according to the age, gender, tumor location,tumor length,clinical T stage,N stage, TNM stage. Adjuvant chemotherapy (AC group) can not prolong progression free survival compared with observation group(median survival: 23.0 months vs 24.0 months log-rank P=0.859). AC group can not improve the median overall survival (32.0 vs 44.4 months, log-rank P=0.482) than observation group.Overall survival at 1, 3 years was 82.5%, 55.5% in the observation group, and 93.0%, 47.5% in the AC group, respectively. a total of 60 patients have Grade 3-4 Hematologic toxicity (AC group 32/43 vs 28/40 observation Group). TITE-CRM show the≥2 times Grade 3-4 Hematologic toxicity frequency were increased significantly in AC group 24/32(75.0%) than 8/28 (28.6%) P=0.001 in observation group. Patients with≥2 times Grade 3-4 Hematologic toxicity have lower median OS (29.4 vs 44.4 months) than that with one time.
Conclusion: Adjuvant chemotherapy can not prolong the survival with improved significantly toxicity in patients with advanced squamous cell oesophagus carcinoma after chemoradiation.
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