TBA (15W182)

Completion of Chemotherapy and Survival Outcomes for Advanced Oesophago-gastric Adenocarcinoma at the Northern Ireland Cancer Centre

Author(s)

Laura Feeney, Michael J Devlin, Peter Gallagher, Jirhe Okugbeni, Kyle Crawford, Rachel Campbell, Claire Harrison, Colin Purcell, Richard C Turkington, Martin Eatock

Department(s)/Institutions

Northern Ireland Cancer Centre

Introduction

The majority of oesophago-gastric adenocarcinoma patients present with locally advanced or metastatic disease and are considered for palliative chemotherapy. Data from the National Oesophago-gastric Cancer Audit (NOGCA) and clinical trials indicates that completion rates for palliative chemotherapy are low and survival is poor.

Aims/Background

We sought to compare chemotherapy and survival outcomes at the Northern Ireland Cancer Centre with published data.

Method

We examined the palliative chemotherapy completion rates and survival of all patients with locally advanced or metastatic oesophago-gastric adenocarcinoma treated at the Northern Ireland Cancer Centre between 2007 and 2012. All patients received Epirubicin, Cisplatin and 5-Fluorouracil/Capecitabine (ECF/X) chemotherapy and survival analysis was performed using the Kaplan-Meier method. Characteristics of completers and noncompleters of chemotherapy were compared using the χ2 test.

Results

Of the 183 patients who received palliative chemotherapy, 80 (43.7%) completed all cycles of their planned treatment, with only 33 (18%) receiving their full planned dose. Reasons for failing to complete chemotherapy included progressive disease (28.4%), acute chemotherapy toxicity (14.2%), death (11.5%) and patient choice (2.2%). Treatment completion was not related to sex, age, performance status, stage or site of primary or metastatic disease. These results compare favourably with NOGCA completion rates of 39.7%.1 The overall response rate was 46.5%, compared to the published rate of 42.7% for the ECF regimen.2. Median progression-free survival (PFS) was 8.1 months and overall survival (OS) 9.7 months, compared to published rates of 7 and 9.4 months for PFS and OS respectively.

Conclusions

Completion rates for palliative chemotherapy for oesophago-gastric adenocarcinoma are comparable to national standards and progression-free and overall survival outcomes exceed published data. The low proportion of patients completing planned treatment and poor survival outcomes indicate the need for better patient stratification and treatment selection in advanced oesophago-gastric cancer.