OGC P02 A comparison of body composition changes between the FLOT and MAGIC regimes in patients with locally advanced oesophageal cancer

Abstract Background Recently, peri-operative FLOT (fluorouracil plus leucovorin, oxaliplatin, and docetaxel) chemotherapy has superseded the ‘MAGIC’ regimen (epirubicin, cisplatin fluorouracil or capecitabine) as standard of care for locally advanced oesophago-gastric adenocarcinoma. However, concerns have been raised regarding toxicity profile FLOT. This study aims to compare changes in body composition between both regimens. Methods 115 patients treated with (n = 61) MAGIC 54) who underwent an oesophagectomy oesophageal gastro-oesophageal junction (GOJ) adenocarcinoma 2014 2020 at Queen Elizabeth Hospital, Birmingham, UK were analysed. Changes pre- post-neo-adjuvant determined by analysis computed tomography imaging. Results In regimes, a large proportion sarcopenic prior starting (FLOT 44.2%, 44.4%; p=0.984). The percentage increased post 63.9%, 57.4%; p=0.474). There was no significant pre vs change L3 skeletal muscle index regimes 2.96 ± 4.03 2.76 4.21; p=0.792). also fat 2.49 22.6 5.78 24.2; p 0.453). Myosteatosis observed 44.3% pre-FLOT 42.6% pre-MAGIC (p=0.857). 62.2% post-FLOT 46.3% post-MAGIC (p=0.085). associated better tumour regression grade compared (p<0.001). Conclusions A oesophageal/GOJ had myosteatosis chemotherapy. further loss occurs during but there difference across regimes. regime pathological response MAGIC.