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.
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.
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.
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.
|Publication status||Unpublished - 01 Nov 2015|
|Event||NCRI Cancer Conference 2015 - Liverpool, United Kingdom|
Duration: 02 Nov 2015 → 05 Nov 2015
|Conference||NCRI Cancer Conference 2015|
|Period||02/11/2015 → 05/11/2015|
The development of a blood-based test of DNA methylation for the earlier detection of high-grade serous tubo-ovarian cancerAuthor: Feeney, L., Jul 2020
Student thesis: Doctoral Thesis › Doctor of Philosophy