Esophagus

Question 1

CROSS trial: P/D/R

Answer 1

P: 366 patients with resectable esophageal cancer
D: surgery +/- neoadjuvant CRT (carboplatin, paclitaxel, 41.4Gy)
R: improved OS with CRT (49mo vs. 24mo)

Question 2

What percentage of patients on the CROSS trial had adeno vs. SCCa?

Answer 2

75% adenocarcinoma
23% squamous cell carcinoma
2% large cell undifferentiated carcinoma

Question 3

Cross trial:
overall path CR
adeno path CR
SCCa path CR

Answer 3

overall path CR: 29%
adeno path CR: 23%
SCCa path CR: 49%

Question 4

RTOG 9405 / INT 0123 (Minsky trial): P/D/R

Answer 4

P: 236 patients with T1-4 N0-1 M0 esophageal cancer
D: concurrent chemotherapy (cisplatin/5-FU) with radiation to 50.4Gy vs. 64.8Gy
R: no difference in OS or LRR with higher radiation dose, multiple deaths in dose escalation arm occurred early in treatment

Question 5

RTOG 8501: P/D/R

Answer 5

P: 121 patients with esophageal cancer
D: CRT (cisplatin/5-FU, 50Gy) vs. RT alone (64Gy)
R: initial randomized portion closed early due to improved OS with CRT, 5yr OS 26% vs. 0%

Question 6

What chemotherapy regimens were used for the following:
RTOG 8501
RTOG 9405
CROSS trial

Answer 6

RTOG 8501: cisplatin/5-FU
RTOG 9405: cisplatin/5-FU
CROSS trial: carboplatin/paclitaxel

Question 7

What radiation doses were used in the following:
RTOG 8501
RTOG 9405
CROSS trial

Answer 7

RTOG 8501: 50Gy with chemo, 64Gy alone
RTOG 9405: 50.4Gy, 64.8Gy (both with concurrent chemo)
CROSS trial: 41.4Gy with chemo