ESTRO 2024 - Abstract Book

S2205

Clinical - Upper GI

ESTRO 2024

References:

(1)doi: 10.1007/s00259014-2824-5; (2)doi: 10.2967/jnumed.110.075861.

1759

Digital Poster

CROSS Vs FLOT in distal or esophageal gastric junction adenocarcinoma. Mono-institutional experience

Najla Slim 1 , Marco Castellano 1 , Elena Mazza 2 , Giorgio Purrello 1 , Paolo Passoni 1 , Ugo Elmore 3 , Miriam Torrisi 1 , Nicole Liscia 2 , Andrea Cossu 3 , Luca Albarello 4 , Francesco Puccetti 3 , Lavinia Barbieri 3 , Sara Broggi 5 , Martina Midulla 1 , Anikò Maria Deli 1 , Laura Giannini 1 , Claudio Fiorino 5 , Stefano Cascinu 2 , Francesco De Cobelli 6 , Riccardo Rosati 3 , Nadia Di Muzio 1 1 IRCCS Ospedale San Raffaele, Radiation Oncology, Milano, Italy. 2 IRCCS Ospedale San Raffaele, Medical Oncology, Milano, Italy. 3 IRCCS Ospedale San Raffaele, Surgery, Milano, Italy. 4 IRCCS Ospedale San Raffaele, Pathological Anatomy, Milano, Italy. 5 IRCCS Ospedale San Raffaele, Medical Phisycs, Milano, Italy. 6 IRCCS Ospedale San Raffaele, Radiology, Milano, Italy

Purpose/Objective:

To evaluate outcomes in patients (pts) with distal and esophageal gastric junction adenocarcinoma treated with neoadjuvant CROSS or FLOT regimen.

Material/Methods:

From April 2014 to August 2022, 122 pts with histological confirmed adenocarcinoma of distal or esophageal gastric Junction were treated in our institution: 52 pts (43%) with CROSS regimen and received weekly paclitaxel 50 mg/m2 + Carboplatin (2 mg/ml/min AUC) concomitant to radiotherapy (41.4 Gy in 23 daily fractions), while 70 pts (57%) received 4 bi-weekly cycles with FLOT (Docetaxel 50 mg/m2, Oxaliplatin 85 mg/m2, Leucovorin 200 mg/m2, Fluorouracil 2600 mg/m2 as a 24 c.i.).

Results:

Fourty-nine pts (94%) treated with CROSS were male vs 54 pts (77%) treated with FLOT and 3 pts (6%) were female in CROSS vs 16 pts (23%) in FLOT. Median age of patients at diagnosis were 61.1 years (39.8-78.5) in CROSS vs 63.4 years (23-81.8) in FLOT pts. cT1, T2, T3, T4 were 1 (2%), 14 (27%), 36 (69%) and 1 (2%) in CROSS pts vs 7 (10%), 10 (14 %), 45 (64%) and 8 (12%) respectively in FLOT group. Forty-six pts (88%) in CROSS were cN+ vs 52 (73%) in FLOT pts. Median length of tumor was 4.6 cm (1-11) in CROSS vs 4.2 cm (2-16 cm) in FLOT. All CROSS pts were treated with Helical Tomotherapy. Major acute toxicity in FLOT pts was gastrointestinal G2 while in CROSS 70% pts had lymphopenia (G3-G4: 52%; G1-G2: 18%), and for this reason only 70% of pts had a full dose of chemotherapy. Similarly in FLOT pts full dose of Chemotherapy was administered in 70% of pts due to toxicity. Median time to restaging was 42 days (14-87). Median time from neoadjuvant treatment and surgery was similar in both group: it