Tolerability of epirubicin, oxaliplatin, and capecitabine chemotherapy in advanced esophagogastric cancer.

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e15078 Background: Oesophago-gastric cancer is the fifth commonest malignancy in the UK, and its incidence is rising. Less than 30% of patients at diagnosis are suitable for curative treatment. Randomised data supports the use of palliative chemotherapy to reduce cancer related symptoms and improve both quality of life and life expectancy in those with incurable disease. Epirubicin, oxaliplatin and capecitabine (EOX) is an established regimen. Its toxicities are well documented and of significant relevance in this patient population where prognosis is limited. Methods: We conducted a retrospective review of patients with advanced oesophago-gastric adenocarcinoma treated with at least 1 cycle of EOX chemotherapy at our institution since 2011. Patient characteristics, toxicities, and need for dose reductions or discontinuation of treatment were analysed. Results: 249 patients were identified; 124 lower oesophageal, 78 gastric, 40 gastro-oesophageal junction and 8 of undefined origin. Patients were predominantly male (184 v 74), median age of 65 and over 92% were of WHO PS 1 or better. 47% of patients completed all 6 recommended cycles of chemotherapy with 53% of these needing a dose reduction of at least one cytotoxic drug. 133 patients discontinued treatment; 41 due to disease progression and 92 due to intolerable toxicities. Significant toxicities reported were: haematological (17%), neurological 11%, and gastrointestinal 13%. 56% reported deterioration in their performance status or profound fatigue. 3 patients discontinued treatment due to cardiac complications. 1 with established myocardial infarction and 2 with non-troponin elevated chest pain. There were no treatment related fatalities. Conclusions: Palliative chemotherapy with EOX improves cancer related symptoms and survival in advanced oesophago-gastric malignancies. In this population tolerance of treatment and avoidance of toxicity is essential.

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