S1110
Clinical – Upper GI
ESTRO 2026
Digital Poster 4075
Neoadjuvant chemo-radiotherapy in the elderly with oesophageal cancer: is therestill a role? Michele Aquilano 1 , Mauro Loi 1 , Marianna Valzano 1 , Pierluigi Bonomo 1 , Alessandra Galardi 1 , Giuseppe Dario Testa 2 , Fabio Cianchi 3 , Laura Fortuna 3 , Daniela Greto 1 , Gabriele Simontacchi 1 , Emanuela Olmetto 1 , Vieri Scotti 1 , Pietro Garlatti 1 , Icro Meattini 1 , Monica Mangoni 1 , Matteo Mariotti 1 , Andrea Rampini 1 , Beatrice Bettazzi 1 , Chiara Mattioli 1 , Luisa Caprara 1 , Marco Banini 1 , Niccolò Bertini 1 , Doruntina Cela 1 , Lorenzo Livi 1 1 Radiation Oncology Department-Careggi Hospital, University of Florence, Florence, Italy. 2 Division of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, AOUC- Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. 3 Department of Clinical and Experimental Medicine, University of Florence, AOUC- Azienda Ospedaliero- Universitaria Careggi, Florence, Italy Purpose/Objective: Following the publication of the ESOPEC and NeXT trials, triplet chemotherapy (TCT) hasbecome the preferred neoadjuvant approach for both oesophageal adenocarcinoma (oAC)and squamous cell carcinoma (oSCC) in several countries. However, in older patients,TCT is often associated with an increased risk of side effects, potentially resulting in anunfavourable risk–benefit ratio. In this context, neoadjuvant (chemo)-radiotherapy (nC-RT)may represent a valuable alternative, particularly from an organ preservation standpoint.This study aimed to evaluate treatment compliance and side effects associated with nC-RTin elderly patients with oAC or oSCC. Material/Methods: Clinical and treatment-related data from consecutive patients aged ≥ 70 years with oAC oroSCC treated with nC-RT at our institution between January 2019 and August 2023 wereretrospectively reviewed. Results: Thirty-four patients were included: 20 (59%) with oSCC and 14 (41%) with oAC. Themedian age was 75 years (range 71–90), and 12 patients (35%) had an ECOGperformance status of 1–2. The median BMI was 23 (range 14–31); 19 patients (56%)experienced a 5– 10% weight loss, and 11 (32%) required nutritional support throughfeeding tube insertion. Radiotherapy was delivered with total doses ranging from 41.4 Gyto 50.4 Gy in 23–28 fractions, according to institutional dose guidance for organs ofinterest. Concurrent chemotherapy was administered in 31 patients (91%), usingcarboplatin–paclitaxel in 27 (79%) and cisplatin– 5-FU in 4 (12%). All patients completedthe planned nC- RT; temporary interruptions occurred in 7 (20%) cases (median duration 3days, range 2–6), mainly due to treatment-related side effects. At least 80% of the
Keywords: Proton Therapy, Hepatocellular Carcinoma, RILD
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