S1064
Clinical – Upper GI
ESTRO 2026
mFOLFIRINOX. Radiotherapy: PREOPANC (36 Gy/15 fractions), long course of radiotherapy LCRT (45–50 Gy/25 fractions). Concomitant chemotherapy: gemcitabine 1000 mg/m ² weekly, capecitabine 825 mg/m ² twice daily. The study aimed to assess the resectability rate after neoadjuvant therapy, pathological response, and overall survival of patients. Results: The study included 44 patients (24 patients with BRPC and 20 patients with LAPC) with a median follow-up of 38.94 months (2.29–68.71 months). Neoadjuvant CHT/RT was indicated in 28/44 patients, neoadjuvant CHT was indicated in 16/44 patients. A total of 13/24 patients (54.2%) with BRPC and 6/20 patients (30%) with LAPC were indicated by MDT for surgical intervention after neoadjuvant therapy. Eleven of 24 patients (45.8%) with BRPC and 4 of 20 patients (20%) with LAPC underwent resection. Four patients (2 BRPC and 2 LAPC) underwent exploration only due to the finding of locally advanced and/or metastatic disease during surgery. The median OS of patients after neoadjuvant CHT/RT was 22.44 months (BRPC) and 24.08 months (LAPC), p=0.050. The median OS of patients after neoadjuvant CHT was 18.94 months (BRPC) and 7.74 months (LAPC), p=0.050. In resected patients, mOS was 39.55 months (neoadjuvant CHT/RT) and 19.39 months (neoadjuvant CHT), p=0.050. In addition, patients treated with neoadjuvant CHT/RT were more likely to have pN0 and R0 status in the resected specimen vs. patients treated with neoadjuvant CHT. Conclusion: Neoadjuvant therapy for BRPC and LAPC allows curative surgery in a proportion of patients. The inclusion of radiotherapy may lead to better locoregional control, which may result in numerically longer patient survival. In the future, it will be necessary to identify factors that will signal a greater benefit of including radiotherapy in the neoadjuvant therapy algorithm. Keywords: pancreatic cancer, neoadjuvant, radiotherapy Digital Poster 392 VMAT-based Lattice Radiotherapy for Large Hepatocellular Carcinoma: Feasibility, Safety, and Early Immune-Compatible Response Yu-Wei Lin 1 , Shao-Wei Chiang 1 , Yang-Wei Hsieh 1 , Chia- Peng Pan 1 , Kung-Hung Lin 2 1 Department of Radiation Oncology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 2 Department of Gastroenterology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
22 patients in arm B). Multicentric enrollment will start in 2026. Planned recruitment period will be 36 months. After the completion of treatment in both arms, patients will be staged every 3 months until liver transplantation, progression or maximal up to 24 months. Primary endpoint is the histopathological response rate after liver transplantation. Secondary endpoints include overall survival, progression free survival, recurrence free survival, the radiological response rate per mRECIST as well as quality of life. Conclusion: TREASURE-TX (AIO-HEP-0124) is a randomized, prospective, multicentric, open-label, phase II trial that will be launched in 2026 and aims at comparing TACE alone versus TACE plus SBRT for patients with HCC as a bridging method to liver transplantation. References: [1] Bauer, U., Gerum, S., Roeder, F., Münch, S., Combs, S. E., Philipp, A. B. et al.High rate of complete histopathological response in hepatocellular carcinoma patients after combined transarterial chemoembolization and stereotactic body radiation therapy. World J Gastroenterol27, 3630-3642, doi:10.3748/wjg.v27.i24.3630 (2021). Keywords: Hepatocellular Carcinoma; TACE; SBRT Digital Poster 286 Neoadjuvant therapy (chemotherapy or chemoradiotherapy) in patients with borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer Marian Liberko 1,2 , Renata Soumarova 1,2 1 Department of Oncology, University Hospital Kralovske Vinohrady, Prague, Czech Republic. 2 Third Faculty of Medicine, Charles University, Prague, Czech Republic Purpose/Objective: The aim of this study is to evaluate the efficacy of neoadjuvant therapy (chemotherapy [CHT] and/or chemoradiotherapy [CHT/RT]) in the treatment of patients with BRPC and LAPC in a real-world clinical setting. It is assumed that neoadjuvant therapy in patients with BRPC and LAPC may lead to potentially curative surgery and that the inclusion of radiotherapy may lead to better oncological outcomes. Material/Methods: A prospective, single-center study of patients with BRPC and LAPC was conducted. Inclusion criteria included patients with histologically verified BRPC and LAPC, WHO performance status 0-1, indicated by a multidisciplinary team (MDT) for neoadjuvant therapy between July 2019 and December 2024. Systemic treatment: induction/neoadjuvant chemotherapy with gemcitabine, gemcitabine + nab-paclitaxel,
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