ESTRO meets Asia 2024 - Abstract Book

S277

Interdisciplinary – Upper GI

ESTRO meets Asia 2024

fractions of 1.8 Gy each, and concurrent chemotherapy Carboplatin/Paclitaxel. Patient demographics, esophageal cancer characteristics, treatments and outcomes were recorded.

Results:

18 patients were identified. 55% were male with median age of 62, and 50% of patients were of Indian ethnicity. A total of 66.7% were located in the distal esophagus, with clinical stage of II (38%), III (50%) and IVA (12%) respectively. Most commonly reported toxicity during CRT were nausea & vomiting (15%), fatigue (20%), dermatitis (11%) and leukopenia (11%). 88% of patients were able to complete the entire neoadjuvant CRT regimen. Out of the 18 patients, only 10 patients (55%) went on to receive surgery within 10 to 14 weeks, while the others either progressed systemically (22%), deemed unresectable (16%) and 1 patient defaulted surgery. Complete resection with no tumor within 1 mm of the resection margins (R0) was achieved in 95% of patients and pathological complete response (pCR) was seen in 1 patient (10%). 30% had pathological lymph nodes.

Of these 10 resectable patients, 3 succumbed to post-operative early mortality (30%). Further follow-up revealed systemic recurrence in 20% of patients while the rest remains stable on surveillance.

Conclusion:

An apparent difference is seen in responses to CROSS neoadjuvant CRT for esophageal cancer in Malaysian patients. Barriers to optimal staging, patient selection for neoadjuvant CRT, timing to surgery and differences in response to anticancer therapy in the multi-ethnic Malaysia population will need further evaluation.

Keywords: esophagus, squamous cell carcinoma, neoadjuvant

References:

1. Lim RZM, Mahendran HA; Malaysian Upper Gastrointestinal Surgical Society (MUGIS). Esophageal squamous cell carcinoma and adenocarcinoma in Malaysia - Pooled data from upper gastrointestinal centers in a multiethnic Asian population. Cancer Epidemiol. 2022 Oct;80:102211. 2. Shapiro J, van Lanschot JJB, Hulshof MCCM, van Hagen P, van Berge Henegouwen MI, Wijnhoven BPL, van Laarhoven HWM, Nieuwenhuijzen GAP, Hospers GAP, Bonenkamp JJ, Cuesta MA, Blaisse RJB, Busch ORC, Ten Kate FJW, Creemers GM, Punt CJA, Plukker JTM, Verheul HMW, Bilgen EJS, van Dekken H, van der Sangen MJC, Rozema T, Biermann K, Beukema JC, Piet AHM, van Rij CM, Reinders JG, Tilanus HW, Steyerberg EW, van der Gaast A; CROSS study group. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015 Sep;16(9):1090-1098.

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