Validation of Prognostic Indices in Locally Advanced and Metastatic Oesophago-gastric Cancer

Devlin Michael, Laura Feeney, Peter Gallagher, Jirhe David-Okubeni, Kyle Crawford, Rachel Campbell, Claire Harrison, Colin Purcell, Richard Turkington, Martin Eatock

Research output: Contribution to conferenceAbstract

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Abstract

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

Methods:
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 non-completers of chemotherapy were compared using the 2 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 age, sex, 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.

Conclusion:
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.
Original languageEnglish
Publication statusUnpublished - 01 Nov 2015
EventNCRI Cancer Conference 2015 - Liverpool, United Kingdom
Duration: 02 Nov 201505 Nov 2015

Conference

ConferenceNCRI Cancer Conference 2015
CountryUnited Kingdom
CityLiverpool
Period02/11/201505/11/2015

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  • Student Theses

    The development of a blood-based test of DNA methylation for the earlier detection of high-grade serous tubo-ovarian cancer

    Author: Feeney, L., Jul 2020

    Supervisor: Mullan, P. (Supervisor), Salto-Tellez, M. (Supervisor) & Beirne, J. P. (Supervisor)

    Student thesis: Doctoral ThesisDoctor of Philosophy

    Cite this

    Michael, D., Feeney, L., Gallagher, P., David-Okubeni, J., Crawford, K., Campbell, R., Harrison, C., Purcell, C., Turkington, R., & Eatock, M. (2015). Validation of Prognostic Indices in Locally Advanced and Metastatic Oesophago-gastric Cancer. Abstract from NCRI Cancer Conference 2015, Liverpool, United Kingdom.