S1087
Clinical – Upper GI
ESTRO 2026
Results: From September 2023 to June 2025, 53 patients have been accrued, of whom 2 withdrew consent after starting treatment and had SBRT off-protocol, and 2 patients were lost to follow-up. The median age was 67 years (range: 56,9 to 90,9 years). All patients had liver cirrhosis, and the cause of liver disease was metabolic dysfunction-associated steatotic liver disease (MASLD) in 39 patients, MetALD in 3 patients, alcohol-related in 2 patients, and others in 6 patients. 35 patients had CPA5 liver function, 8 had B6, and 6 had B7 or worse. 28 patients had Barcelona Clinic Liver Cancer (BCLC) stage A HCC, 52% had a single HCC, and the median HCC size was 4.4 cm. (48.7 cc). Median SBRT dose was 45Gy (range: 27.5 to 50Gy), and the median number of fractions was 5 fractions (range: 5 to 15 fractions). Overall survival (OS) at 1 year was 87%, local control (LC) at 1 year was 93%, and disease-free survival at 1 year was 60%. No patients have developed GI bleeding related to SBRT. In the absence of disease progression, only 1 patient had worsening of liver function in the CPT score two or more points in the first three months after SBRT. Conclusion: This is the first prospective study of SBRT for HCC reported from Latin America. In our cohort, SBRT achieved 1-year OS and LC rates comparable to previous studies, with low side effect rates. Quality-of- life assessment and biomarker analyses are ongoing. Keywords: Hepatocellular carcinoma, liver cancer, SBRT chemoradiotherapy on pathologic complete response and lymphopenia in patients with esophageal cancer David C. Qian 1 , Ethan T. Hanks 2 , Justin Fang 3 , Suraj V. Komatineni 4 , Yiqing Chen 5 , Jenny J. Li 6 , Mariela Blum Murphy 6 , Jaffer A. Ajani 6 , Joe Y. Chang 1 , Zhongxing Liao 1 , Quynh-Nhu Nguyen 1 , Wayne L. Hofstetter 7 , Kyle G. Mitchell 1 , Mara B. Antonoff 1 , Garrett L. Walsh 7 , David C. Rice 7 , Reza J. Mehran 7 , Stephen G. Swisher 7 , Ara A. Vaporciyan 7 , Zachary S. Buchwald 8 , Ravi Rajaram 7 , Steven H. Lin 1 1 Department of Thoracic Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. 2 McGovern Medical School, The University of Texas Health Science Center, Houston, USA. 3 College of Osteopathic Medicine, Sam Houston State University, Conroe, USA. 4 Boonshoft School of Medicine, Wright State University, Dayton, USA. 5 Department of Epidemiology and Biostatistics, Texas A&M University School of Public Health, College Station, USA. 6 Department of GI Medical Oncology, The Digital Poster Highlight 2594 Time-of-day effects of neoadjuvant
University of Texas MD Anderson Cancer Center, Houston, USA. 7 Department of Thoracic Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA. 8 Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, USA Purpose/Objective: Circadian influence of oncologic treatment efficacy has been implicated across numerous cancers and treatment modalities[1–3]. Since lymphopenia is prognostically unfavorable for patients with esophageal cancer undergoing chemoradiotherapy (CRT)[4] and lymphocyte trafficking is also circadian- regulated[5], we hypothesize that differential treatment response may be attributable to varying lymphocyte depletion by time-of-day radiotherapy (RT) delivery. Previous time-of-day studies of oncologic treatments have focused on survival, which is inextricably linked to confounding factors that also impact appointments. We present the first report of surgical pathology and absolute lymphocyte count (ALC) as more objective measures of variations in time-of-day related treatment response. Material/Methods: We identified all patients with non-metastatic esophageal cancer who had received neoadjuvant CRT followed by esophagectomy within a multi-site academic hospital system between 2004 and 2024. These 789 patients were partitioned into individuals who did (79%) and did not (21%) receive a majority (defined as ≥ 60%) of their RT fractions after 12:00. The two groups then underwent propensity score- matching with strict caliper width 0.1 and up to 4:1 matching on baseline clinicopathologic characteristics (Table 1). The association between pathologic complete response (pCR) and time-of-day RT group was computed using multivariable logistic regression.Table 1. Clinicopathologic characteristics
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