Background:
Oesophageal cancer is the eighth most common cancer worldwide. Preoperative chemoradiotherapy (CRT) using carboplatin/paclitaxel improves survival among patients with potentially curable oesophageal or oesophagogastric-junction cancer. This retrospective audit investigated patients treated with neoadjuvant or definitive carboplatin/paclitaxel-based CRT, evaluating survival outcomes and recurrence patterns at our institution.
Methods:
A retrospective audit was conducted with approval from the Eastern Health ethics committee (QA97-2016). The medical records database was used to identify patients receiving CRT using carboplatin/paclitaxel as defined by the CROSS protocol between May 2014 and December 2016. Data was collected on pre-specified parameters including: basic demographics, histology, treatment response, completion rates, time from diagnosis to disease recurrence, site of disease recurrence, subsequent treatment and survival.
Results:
A total of 26 patients were identified. 65% of patents had adenocarcinoma and 35% squamous cell carcinoma. Of the 26 patients, 14 were receiving neoadjuvant chemoradiotherapy while 12 had definitive treatment, 3 of whom had local relapse and were having salvage definitive CRT.
All bar 2 patients completed planned treatment; one due to oesophageal fistula formation and one due to poor tolerance - these were excluded from the analysis of disease recurrence.
With a median follow-up of 17 months (range 7 - 36 months) for the patients who completed treatment, 83% remain alive and 25% (6/24) have recurred. Median time to disease recurrence was 13 months (range 10 - 20 months), 1 patient had isolated nodal recurrence and was treated with radical CRT, 5 had distal metastases.
Conclusion:
In this community-based cohort of patients with primary oesophageal or oesophagogastric-junction cancer, carboplatin/paclitaxel was feasible and well tolerated. With median follow-up of 17 months, 75% of patients remain disease free.