2009 ASCO Annual Meeting Abstracts
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Treatment intensification by induction chemotherapy (ICT) and radiation dose escalation in locally advanced squamous cell anal canal carcinoma (LAAC): Definitive analysis of the intergroup ACCORD 03 trial.
Sub-category: Colorectal Cancer (including liver metastases) Category: Gastrointestinal (Colorectal) Cancer Meeting: 2009 ASCO Annual Meeting Citation: J Clin Oncol 27:15s, 2009 (suppl; abstr 4033) Abstract No: 4033
Attend this session at the ASCO Annual Meeting! Session: Gastrointestinal (Colorectal) Cancer Type: Poster Discussion Time: Monday June 1, 8:00 AM to 12:00 PM Location: Level 2, W240A Discussion: Monday June 1, 11:00 AM to 12:00 PM Location: Level 2, West Hall E1 Personalize your Annual Meeting experience with a suggested or customized itinerary!
Author(s): T. Conroy, M. Ducreux, C. Lemanski, E. Francois, M. Giovannini, F. Cvitkovic, X. Mirabel, O. Bouché, C. Montoto-Grillot, D. Peiffert; Centre Alexis Vautrin, Vandoeuvre-Les Nancy, France; Institut Gustave Roussy, Villejuif, France; Centre Val d'Aurelle, Montpellier, France; Centre Antoine Lacassagne, Nice, France; Institut Paoli-Calmettes, Marseille, France; Centre René Huguenin, Saint-Cloud, France; Centre Oscar Lambret, Lille, France; Centre Hospitalier Universitaire, Reims, France; FNCLCC, Paris, France Abstract: Background: Concomitant radiochemotherapy (CRT) is the standard treatment of LAAC. The addition of an ICT (2 cycles of 5 FU-Cisplatin) and of a higher dose of irradiation boost (HDRT) to CRT were evaluated in a factorial 2X2 arms trial (A= ICT; B=ICT+HDRT; C= Reference arm = Pelvic RT 45 Gy/25 fractions with 2 cycles of 5FU-Cisplatin and a boost of 15 Gy; D= HDRT). The aim of the study was to detect a increase from 70 to 85% of colostomy-free survival (CFS) at 3 years. Methods: 307 pts with T2 > 4 cm or T3-T4 Nx or any T, N1-3 M0 LAAC were included. Mean age was 59 y and sex-ratio was 1/6. The 4 arms were well balanced concerning the sex-ratio, age, stage, T size and differentiation. Results: 306/307 pts were eligible. Toxicities were similar in the 4 arms (toxic deaths: A=4, B=2, C=2, D=1). The compliance was: 99% for ICT, 100% for pelvic RT-CT, and 96% for the boost. The tumour complete response (+ partial response) at 2 months were: A=78% (+18%), B=86% (+13%), C=74% (+21%), D=74 % (+22%) (NS). The median follow-up was 43 months. Overall failure rates were 28% (A=28%, B=21%, C=30%, D= 30%). The actuarial results at 3 years were: CFS was 83%: A= 83%, B= 85%, C= 86%, D= 80% with no significant difference of ICT nor HDRT (A+B=84% vs C+D=83% for ICT; A+C= 84% vs B+D=83% for HDRT). Local control was 88%: A= 80%, B= 96%, C= 90 %, D= 87%: (NS). Event-free survival was 71% : A= 70%, B= 78%, C= 67%, D= 68%: (NS). Overall survival was 78% at 3 y (73% at 5 y) with no difference between arms. Specific survival was 84 % : A= 79%, B= 88,5%, C= 89%, D= 79%: (NS) Conclusions: Neither ICT nor HDRT improved the CFS at 3 years, nor the secondary end points.
Abstract Disclosures Faculty and Discussant Disclosures Annual Meeting Planning Committee Disclosures 2009 Annual Meeting Proceedings Part I Errata Other Abstracts in this Sub-Category: 1. A phase III trial comparing mFOLFOX6 to mFOLFOX6 plus bevacizumab in stage II or III carcinoma of the colon: Results of NSABP Protocol C-08.