Toxicity and Outcomes in Patients With and Without Esophageal ...

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C.H. Crane: Honoraria; EMD Serono, Inc. Consultant;. Vertex Pharmaceuticals. A.X. Zhu: None. T.I. Hong: None. 2427. Clinical and Biological Prognostic Factors ...
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Volume 96  Number 2S  Supplement 2016 damage, rather than to traditional, acute mechanisms of RT-induced hematologic toxicity.

Abstract 2426; Table 1. Effects of mean liver dose (MLD) on change in platelet count Time Point MLD >[19 GyE (vs. RT Week 4 [25 K/uL Drop in Platelets (95% CI)

P

1.0 (0.4, 3.0) 1.8 (0.6, 5.1)

0.977 0.270

4.0 (1.4, 11.4)

0.010

Conclusion: Our predictive model could distinguish patients at high risk from patients at low risk for LRR. Similar to thoracic ESCC patients at high risk, LRR primarily involved the upper thorax (supraclavicular/cervical site, mediastinum above the carina, and anastomoses), and this area must be considered in future study designs for radical tri-modality treatment. Author Disclosure: S. Liu: None. S. Anfossi: None. Y. Zheng: None. M. Cai: None. J. Fu: None. B. Qiu: None. H. Yang: None. Q. Liu: None. J. Fu: None. M. Liu: None. J.K. Burks: None. S.H. Lin: None. J. Reuben: None. H. Liu: None.

2428 Author Disclosure: M.A. Dyer: None. E.I. McDonnell: None. B.Y. Yeap: Employee; Massachusetts General Hospital. Consultant; Harvard Clinical Research Institute. Scientific Advisory Board; SISCAPA Assay Technologies. Advisory board; LUNGevity Foundation. Task force; Society for Immunotherapy of Cancer. N. Depauw: None. J.A. Wolfgang: None. J.Y. Wo: None. T.F. DeLaney: Honoraria; UpToDate, Oakstone Medical Publishing. Consultant; Amgen, Gerson Lehman Consulting. E. BenJosef: None. C.H. Crane: Honoraria; EMD Serono, Inc. Consultant; Vertex Pharmaceuticals. A.X. Zhu: None. T.I. Hong: None.

2427 Clinical and Biological Prognostic Factors for Locoregional Recurrence in Patients With Thoracic Esophageal Squamous Cell Carcinoma Treated With Radical 2-field Lymph Node Dissection: Results From Long-term Follow-up S. Liu,1 S. Anfossi,2 Y. Zheng,1 M. Cai,1 J. Fu,1 B. Qiu,1 H. Yang,1 Q. Liu,1 J. Fu,1 M. Liu,1 J.K. Burks,3 S.H. Lin,4 J. Reuben,3 and H. Liu1; 1State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China, 2The University of Texas MD Anderson Cancer Center, Houston, TX, 3The University of Texas MD Anderson Cancer Center, Houston, China, 4Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX Purpose/Objective(s): To determine the clinical and biological prognostic factors for locoregional recurrence (LRR) in patients with thoracic esophageal squamous cell carcinoma (ESCC) undergoing radical two-field lymph node resection (2FLD). Materials/Methods: A total of 462 patients diagnosed with thoracic ESCC underwent radical esophagectomy between March 2001 and May 2010 at our Center. Clinical characteristics, CD44 expression, and tumor infiltrating lymphocyte (TIL) levels were evaluated in 198 patients who underwent R0 dissection with long-term follow-up. Partial Cox regression analysis with leave-one-out cross-validation was performed to validate the selected risk factors. Results: With a median follow-up of 54 months (range, 6-152 months), the 5-year local failure-free survival (LFFS) rate of 198 patients was 62.5%. Multivariate analysis revealed that T stage (P Z 0.043), pathological positive tumor above the carina (P Z 0.000), CD44 expression level (P Z 0.045) and TIL level (P Z 0.007) were prognostic factors for LFFS. The Cox model with risk scores estimated from expression data had an area under the curve (AUC) value of 83.6% with SE Z 0.029 (95% CI: 0.78 to 0.89) for the prediction of 5-year LFFS. The best cut-off value for sensitivity and specificity was 11.19 (sensitivity: 83%; specificity: 71%). This cut-off value was used to divide the 198 patients into a high-risk group (sum score 11.19) and a low-risk group (sum score < 11.19) for LRR. Patients at high risk had significantly shorter 5-year LFFS than patients at low risk (25 months vs median not reached; P Z 0.000). The LRR pattern revealed significantly high incidences of recurrent disease at the supraclavicular and cervical sites, mediastinum (above the carina), and anastomosis.

Toxicity and Outcomes in Patients With and Without Esophageal Stents in Locally Advanced Esophagus Cancer S. Francis,1 S. Lloyd,2 A. Orton,2 and C.J. Anker3; 1University of Utah Huntsman Cancer Institute, Salt Lake City, UT, 2Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, 3University of Vermont Cancer Center, Burlington, VT Purpose/Objective(s): Stent placement is often considered to relieve severe dysphagia in patients with locoregionally advanced esophageal cancer. We sought to determine effects of esophageal stenting on acute toxicities and oncologic outcomes in patients treated with radiation therapy (RT). Materials/Methods: Patients treated with RT with curative intent for locoregionally advanced esophageal cancer at our institution were retrospectively analyzed. Chi-squared analysis was used to compare demographic and tumor characteristics between patients with or without esophageal stenting prior to RT. Univariate (UV) and multivariate (MV) logistic regression modeling was used to identify predictors for acute toxicities. UV and MV Cox proportional hazards modeling was used to identify factors associated with survival. In the respective MV regression models, variables that had an association with either toxicity or death, defined as P