S1080
Clinical – Upper GI
ESTRO 2026
1 Department of Radiotherapy, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden. 2 Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. 3 Medical Unit of Head, Neck, Lung and Skin Cancer, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden. 4 Department of Upper Abdominal Diseases, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden Purpose/Objective: Definitive chemoradiotherapy (dCRT) represents an established curative approach for esophageal cancer, although trimodality therapy including surgery is standard of care for most patients. This multicenter study evaluates dCRT practices and outcomes in Sweden. Material/Methods: The study cohort was identified through a national cancer registry, supplemented with treatment and follow-up information from medical records. Patients scheduled for dCRT between January 1, 2007, and December 31, 2020, were included. Patients who received ≥ 50 Gy of radiotherapy and ≥ 60% of the planned chemotherapy dose were analyzed as a separate group. This analysis examined the group both as a whole and with a specific focus on radiotherapy dose delivered.Categorical variables were analyzed using the chi-square test, Fisher’s exact test, and logistic regression. Survival was evaluated with the Kaplan–Meier method and a multivariable Cox proportional hazards regression Results: The dCRT intention-to-treat cohort included 390 patients (median age: 71 years), with 62.6% squamous cell cancer, 78.2% T-stage 3–4, and 57.4% node- positive disease. The 2- and 5-year overall survival rates were 41% and 23%, respectively, with progression-free survival rates of 32% and 20%. Among patients who received at least 50 Gy and 60% of the planned chemotherapy dose (N=313), the 2- and 5-year overall survival rates were 46% and 25%, and progression-free survival rates 35% and 22%. Median overall survival was 21 months for patients treated with ≥ 60 Gy and 23 months for those treated with 50– 54 Gy (p=0.62) (see image). Locoregional recurrence degree did not differ significantly between the two groups (34% vs 26%, p=0.13). Grade ≥ 3 acute adverse events were more frequent in the ≥ 60 Gy group (70% vs 55%; OR 1.93, p=0.006) (see table), whereas late grade ≥ 3 adverse events were similar (34% vs 31%; OR 1.17, p=0.53). Numbers of strictures (15% vs 11%; p=0.89) and airway fistulas (5% vs 7%; p=0.63) were comparable. Eight deaths related to late adverse events occurred in the ≥ 60 Gy group and two in the
50–54 Gy group (p=0.20). In the multivariable analysis proximal tumor location was the only significant predictor of overall survival (HR 0.58, p=0.025).
Conclusion: Five-year overall survival of 23% in this cohort is consistent with previously reported outcomes. While survival outcomes were similar for patients treated with 50-54 Gy and ≥ 60 Gy, treatment with ≥ 60 Gy was linked to a higher incidence of acute side effects, and a numerically greater, though not statistically significant, number of deaths related to late adverse events. Keywords: Esophageal cancer, chemoradiotherapy, side effects Digital Poster 1981 Neoadjuvant Concurrent Chemoradiotherapy with Hyperthermia for Resectable Esophageal Squamous Cell Carcinoma Mau-Shin Chi 1 , Jeng-You Wu 2,3 , Kai-Lin Yang 1 , Kwan- Hwa Chi 1 1 Department of Radiation Therapy & Oncology, hin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. 2 Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 3 Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei, Taiwan Purpose/Objective: Neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgery remains the standard of care for locally advanced esophageal cancer. Hyperthermia has been shown to enhance tumor radiosensitivity and modulate the immune microenvironment. This study aimed to evaluate the feasibility and clinical outcomes of incorporating loco-regional hyperthermia into
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