S1091
Clinical – Upper GI
ESTRO 2026
Poster Discussion 3121
confidence interval [CI], 63.5-75.8) and 56.4% (95% CI, 49.3-63.2), 93.4% (95% CI, 88.7-96.2) and 90.8% (95%CI, 85.1-94.5), and 39.9% (95% CI, 33.6-46.5) and 27.9% (95% CI, 22.0-34.4), respectively (figure).
Response and acute toxicity evaluation after intensity modulated proton chemoradiotherapy for locally advanced esophageal cancer. Yvonne LB Klaver 1,2 , Emmeline G Peters 1,3 , Rutger TT Bartels 1,3 , Niels den Haan 1,2 , Henk H Hartgrink 4 , Bianca Mostert 5 , Barbara LT Rijksen 1,6 , Marije Slingerland 7 , Kees Spruijt 1 , Quinten Telkamp 1 , Bas PL Wijnhoven 8 , Mischa S Hoogeman 1,3 , Joost JME Nuyttens 3,1 1 HollandPTC, HollandPTC, Delft, Netherlands. 2 Department of Radiotherapy, Leiden University Medical Center, Leiden, Netherlands. 3 Department of Radiotherapy, Erasmus MC Cancer Institute University Medical Center, Rotterdam, Netherlands. 4 Department of Surgery, Leiden University Medical Center, Leiden, Netherlands. 5 Department of Medical Oncology, Erasmus MC Cancer Institute University Medical Center, Rotterdam, Netherlands. 6 Department of Radiotherapy, Haaglanden Medical Center, 's- Gravenhage, Netherlands. 7 Department of Medical Oncology, Leiden University Medical Center, Leiden, Netherlands. 8 Department of Surgery, Erasmus MC Cancer Institute University Medical Center, Rotterdam, Netherlands Purpose/Objective: Chemoradiotherapy (CRT) plus surgery or definitive CRT (dCRT) are curative treatment options for locally advanced esophageal cancer (EC)1. With intensity- modulated proton therapy (IMPT), reduction of heart and lung dose can be achieved as compared to photon therapy. In the Netherlands, EC patients with an indication for chemoradiotherapy (T0-3N0-2M0 disease) are selected for IMPT with a model based approach using Normal Tissue Complication Probability (NTCP) modelling for predicted 2-year mortality based on reduction of mean heart dose2. In this study we assessed response and acute radiotherapy-related toxicities in EC patients treated with IMPT. Material/Methods: Patients were treated with robustly optimized IMPT for neoadjuvant treatment (nCRT, total dose of 41.4 GyE (RBE=1.1) in 23 fractions) or dCRT in 28 fractions to 50.4 GyE. All patients were scheduled for either five (nCRT) or six (dCRT) weekly cycles of carboplatin/ paclitaxel concurrently. Active surveillance was offered to patients with clinical complete response (CR) after nCRT according to the SANO-2 trial protocol3. Results: All EC patients treated with IMPT CRT between October 2021 and August 2025 who gave informed consent (n=324) were included in this prospective study (266 received nCRT and 58 dCRT). Patient characteristics are shown in table 1. Model-based selection reduced the mean NTCP for 2-year mortality
In the multivariate analysis for OS, age, performance status, maximum tumour diameter, and modified albumin–bilirubin grade were identified as significant prognostic factors. Grade 3 AEs occurred in five patients, the most common being elevated liver enzymes and hypoalbuminemia. No Grade ≥ 4 AEs or treatment-related deaths were observed. Three patients, including one suspected case, developed RILD, and 17 showed a ≥ 2-point increase in the Child– Pugh score. Conclusion: These findings confirm that CIRT is an effective, safe, and potentially curative treatment for HCC. References: Shibuya K et al. Short-course carbon-ion radiotherapy for hepatocellular carcinoma: A multi-institutional retrospective study. Liver Int. 2018 Dec;38(12):2239- 2247. Keywords: hepatocellular carcinoma, carbon-ion radiotherapy
Made with FlippingBook - Share PDF online