S1092
Clinical – Upper GI
ESTRO 2026
Conclusion: IMPT for CRT in this patient cohort with EC reduced mean heart and lung dose with 51% and 55% compared to photon treatment. IMPT was well tolerated and shows promising results. References: 1. van Hagen, et al. Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer. N Engl J Med 2012;366:2074-20842. Muijs, et al. National indication protocol for proton radiotherapy in esophageal cancer patients in the Netherlands. Radiother Oncol 2025 Sep 24:111164. 3. van der Wilk, et al. Neoadjuvant chemoradiotherapy followed by active surveillance versus standard surgery for oesophageal cancer (SANO trial). Lancet Oncol 2025 Apr;26:425-4364. https://dctd.cancer.gov/research/ctep-trials/for- sites/adverse-events/ctcae-v4.pdf Keywords: Proton Therapy, Esophageal Cancer Digital Poster 3134 SBRT: A highly effective approach for local control of hepatocellular carcinoma Andrea Ejimeno 1 , Clàudia Valls 2 , Sheila Alfonso 3 , Nicolás Martínez 3 , Berta Cuyàs 2,4 , Adolfo Gallego 2 , Gemma Calvet 1 , Scarlet Marie Crespo 1 , Maria Magdalena Piedra 1 , Belén Sopena 1 , Alexandre Gibrat 1 , Ivanna Samofalova 1 , Nuria Farré 1 , Ana Maria Soto 1 , Joan Carles Julià 1 , Josep Isern 1 , Majercakova Katarina 1 , Mera Arantxa 1 , Montezuma Laura 1 , Otero Eugènia 1 , Jady Vivian Rojas 1 , Antonio Vila 1 , Gemma Sancho 1 , Josep Balart 1 1 Radiation Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 2 Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 3 Radiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 4 CIBER, CIBEREHD, Madrid, Spain Purpose/Objective: Recently, the European Association for the Study of the Liver endorsed SBRT as an alternative for patients with unresectable (or recurrent) single hepatocellular carcinoma (HCC) who are unsuitable for thermal ablation or TACE. We aimed to evaluate the local control (LC of targets) and tolerance outcomes of a series of patients treated for HCC with SBRT at our Hospital. Material/Methods: All patients were discussed with and approved by the MDT board. Commercial body vacuum systems without abdominal compression were utilized. Two independent simulation scans were performed in expiration breath-hold (EBH) to precisely locate the targets and organs at risk, and to determine anatomical variations according to the Van Herk
from 38% (photons) to 28% (protons). Mean heart and lung dose were reduced substantially (table 2). Median (range) follow up (FU) from start of radiation was 402 days (41-1331) for nCRT and 377.5 days (46-1149) for dCRT patients. IMPT was completed in 316 (98%) of patients. In 10 patients (17%) in the dCRT group and 14 patients (5%) in the nCRT group, grade 3 dysphagia4 developed during or within one month after CRT. Three of 324 patients (1%) of all nCRT, developed grade 4 complications (perforation, sepsis, bleeding).Surgery was performed in only 145 patients (53%) undergoing nCRT. A pathological CR was achieved in 28 (20%) patients. In 60 of 266 patients (23%), a persisting clinical CR was observed during active surveillance (median FU 393 (120-1135) days). Other reasons for not operating were metastatic disease at first evaluation (n=22; 8%), and during active surveillance (n=16; 6%), deterioration of condition (n=6; 2%), irresectable disease (n=5; 2%), patient request (n=2) and FU < 3 months (n=10; 4%).
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