S1108
Clinical – Upper GI
ESTRO 2026
outcomes for patients with oesophageal cancers treated on an MR-Linac. Material/Methods: Patients with histologically confirmed oesophageal carcinoma were prospectively enrolled at a single centre. Eligible patients with non-metastatic, locoregional disease received curative intent concurrent chemoradiotherapy with intensity- modulated radiation therapy on a 1.5T MR-Linac. Online adaptive workflows (Adapt to Position or Adapt to Shape) were used as clinically indicated based on daily anatomy. Toxicity was assessed weekly during treatment using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0, with the maximum grade over the treatment period reported. QoL was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-OG25 questionnaires at baseline and at 3-month follow-up. Clinical outcomes including local control and survival status were recorded at last follow-up. Results: Six patients (four squamous cell carcinomas and two adenocarcinomas) were enrolled, with a mean age of 70.5 (range 57-82). Four patients had stage II disease, one had stage IIIB and one had stage IV. Two patients received neoadjuvant chemoradiotherapy per the CROSS protocol (41.4 Gy in 23 fractions), and four received definitive chemoradiotherapy (50.4 Gy in 28 fractions).All patients completed planned treatment, with a median treatment time per fraction from first MR image to beam-off of 26.6 minutes (IQR 24.2 - 29.9). At a median follow-up of 6.6 months (range 3.6- 25.9 months), both neoadjuvant patients achieved pathological complete response. One patient died of metastatic disease, while local control was maintained in the remaining patients.No grade 3 or higher toxicities were observed. The most common adverse events were fatigue (83% grade 1, 17% grade 2), nausea (17% grade 2), dermatitis (33% grade 1), dysphagia (33% grade 1), and weight loss (17% grade 1). QoL remained stable from baseline to 3-month follow up. For QLQ-C30 (n=3 paired), the mean overall score increased by 6.95 points (95% CI -21.03 to 21.03, p=0.625), with global health status/QoL improving by 8.33 points (95% CI -14.43 to 14.43, p=0.423). For QLQ- OG25 (n=4 paired), the overall score improved by 2.17 points (95% CI -5.82 to 10.16, p=0.451), with decreased odynophagia and weight loss while dysphagia remained unchanged. Conclusion: Treatment on MR-Linac was feasible and well tolerated for oesophageal cancers, achieving 100% treatment completion without ≥ grade 3 toxicity, while maintaining QoL at 3 months. Our results support ongoing accrual and long-term evaluation of clinical outcomes for MR-guided radiotherapy. References:
recognized as accurate, though not mandatory, tracking tools (80%). Daily cone-beam CT was unanimously confirmed as the minimum verification standard. All experts emphasized the need for institutional protocols that specify acceptable intervals for correcting both rotational and translational setup errors.
Conclusion: This study represents the first national,
multidisciplinary consensus defining IGRT standards for upper-GI malignancies. The high agreement levels among the 20 participants confirm a shared vision for motion-managed, image-verified, and quality-assured treatment delivery, fostering consistency, safety, and precision in one of the most complex areas of radiotherapy. Keywords: IGRT, Upper-GI, Consensus
Digital Poster 3958
MR-Linac radiotherapy for oesophageal cancers: A feasibility study in an Australian public hospital Su Chen Fong 1,2 , Richard Khor 1 , Morikatsu Wada 1 , Eddie Lau 3,4 , Kurl Jamora 1 , David S. Liu 5,6 , Niall C. Tebbutt 7,4 , Geoff Chong 7 , Briana Farrugia 1 , Leah McDermott 1 , Mark Tacey 1 , Sergio Uribe 2 , Sweet Ping Ng 1,2 1 Department of Radiation Oncology, Austin Health, Melbourne, Australia. 2 Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia. 3 Department of Radiology and Molecular Imaging Therapy, Austin Health, Melbourne, Australia. 4 University of Melbourne, UOM, Melbourne, Australia. 5 Upper Gastrointestinal Surgery Unit, Division of Surgery, Anaesthesia and Procedural Medicine, Austin Health, Melbourne, Australia. 6 Victorian Interventional Research and Trials Unit, Department of Surgery, University of Melbourne, Melbourne, Australia. 7 Department of Medical Oncology, Austin Health, Melbourne, Australia
Purpose/Objective: This study evaluates the feasibility, toxicity, and early
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