Definitive Chemoradiotherapy for Oesophageal Cancer: a Retrospective Institutional Review

Abstract

Oesophageal cancer has high mortality, with currenttreatments often causing significant toxicity. Thisretrospective study compared outcomes of twochemoradiotherapy regimens: IV cisplatin withinfusional 5-fluorouracil (cis-5FU) versus IVcarboplatin with paclitaxel (carbo-taxol). Data frompatients treated definitively at the Mid North Coastand Northern NSW Cancer Institutes between 2017-2022 were analysed. All patients had a radiotherapydosage of greater than or equal to 50Gy, based onINT 0123, which found no benefit beyond 50.4 Gywith cis-5FU (1). The carbo-taxol regimen wasadapted from the CROSS trial (2). Although not testedas definitive therapy, it is often used due to lowertoxicity and favourable response rates.Of the 172 patients, 44 received cis-5FU and 128received carbo-taxol. Histological subtypes were:41% squamous cell carcinoma (SCC), 58%adenocarcinoma, 1% mixed. Three-year overallsurvival (OS) was 30.8% with cis-5FU and 19% withcarbo-taxol. Across the cohort, 3-year OS was 30.3%in SCC and 17.6% in adenocarcinoma. Theseinstitutional results are consistent with publisheddata, with better outcomes in SCC and with cis-5FU.This is the largest Australian cohort evaluatingdefinitive chemoradiotherapy in oesophagealcancer.Acute and long-term toxicities are currently beinganalysed and will be presented in the final poster.