S1111
Clinical – Upper GI
ESTRO 2026
Results: Based on the pretreatment liver function, 30 and 6 patients were categorized as Child-Pugh class A and B, respectively. The median follow-up time was 16 months (range 6-64 months). The 2-year OS, PFS, and LC rates were 82%, 36%, and 100%, respectively. RILD occurred in 9 patients (25%). The median of mean dose to normal liver was 8.1 Gy (range 2.7-16.2 Gy). The median values of LHL15 were 0.82 (range 0.79- 0.91) and 0.93 (range 0.77-0.96) in the RILD and non- RILD groups. The value of LHL15 in the RILD group was lower (p = 0.001). Conclusion: The LHL15 value may be useful in helping predict RILD in the patients of HCC. Keywords: Liver, Liver damage, SBRT Digital Poster Highlight 4170 Clinical outcomes of adaptive MRI-guided stereotactic body radiation therapy for pancreatic cancer in a 169-patient cohort Pia Braagaard Hartfelt 1 , Anne L. H. Bisgaard 2 , Mathilde Weisz Ejlsmark 1,3 , Rana Bahij 1,3 , Tine Schytte 1,3 , Faisal Mahmood 3,2 , Per Pfeiffer 1,3 , Uffe Bernchou 3,2 1 Department of Oncology, Odense University Hospital, Odense, Denmark. 2 Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Odense, Denmark. 3 Department of Clinical Research, University of Southern Denmark, Odense, Denmark Purpose/Objective: Adaptive MRI-guided stereotactic body radiation therapy (SBRT) represents a promising treatment modality for patients with pancreatic cancer (PC)(1). This study evaluates overall survival (OS), progression-free survival (PFS), freedom from local progression (FFLP) and toxicity in patients diagnosed with locally advanced pancreatic cancer (LAPC) or local recurrent pancreatic cancer treated with adaptive SBRT on an MRI-Linac. Material/Methods: In this prospective ongoing study, patients with LAPC or local recurrence received either 50 Gy/5 fractions or 60 Gy/8 fractions adaptive MRI-guided SBRT on a 1.5T MRI-Linac. Prior to radiotherapy, patients with LAPC received 2-6 months of combination chemotherapy (unless contraindicated) without evidence of disease progression. Data regarding progression, toxicity and survival were prospectively collected through the MOMENTUM study (NCT04075305)(2) and continuously updated from medical records. OS, PFS and FFLP were evaluated at cut-off date (September 24, 2025) using Kaplan-Meier plots. Potential follow-up time was calculated using the reverse Kaplan-Meier method(3).Toxicity was graded using CTCAE v.5.0 at
plannedchemotherapy cycles were delivered in 25 (75%) patients. Grade ≥ 3 adverse eventsoccurred in 9 (25%) patients, consisting primarily of hematological disorders (20%, n = 7)and pneumonitis (5%, n = 2). Surgery was performed in 21 (62%) patients, while omissionwas due to disease progression within two months after nC-RT (n = 8, 23%) or justified bytumour location and/or complete clinical response (n = 5, 15%). Conclusion: In older patients ( ≥ 70 years) with oesophageal adenocarcinoma or squamous cellcarcinoma, nC-RT demonstrated acceptable tolerability and moderate treatmentadherence. Considering the progressive ageing of the cancer population, further studiesare warranted to identify predictive factors for adverse events and explore multidisciplinarystrategies—such as oncogeriatric assessment, prehabilitation, and personalizedsupportive care—to optimize outcomes and maintain treatment precision while minimizingset- up variations. Keywords: elderly, esophageal cancer; chemo- radiotherapy prognostic analysis of radiation-induced liver damage following stereotactic body radiotherapy for hepatocellular carcinoma. Yutaka Toyomasu, Akito Taniguchi, Kazushi Saihara, Yoshitaka Suzuki, Kazuki Omori, Takamitsu Mase, Akinori Takada, Hajime Sakuma, Yoshihito Nomoto Radiology, Mie University Hospital, Tsu, Japan Purpose/Objective: To predict the radiation-induced liver damage (RILD) is important in the treatment of hepatocellular carcinoma (HCC) using stereotactic body radiotherapy (SBRT). However, prognostic factors of RILD are not identified. This retrospective study aimed to evaluate outcomes in patients with HCC treated with SBRT at a single institution to estimate prognostic factors for RILD. Material/Methods: Between June 2019 and January 2025, 36 patients with HCC underwent SBRT and 99mTc-GSA SPECT. Patients Digital Poster 4163 were received SBRT (50Gy or 35Gy in 5 fractions). Pretreatment liver function was evaluated with Child- Pugh classification and index of 99mTc-GSA scintigraphy (LHL15). RILD was defined as a worsening of two or more points in the Child-Pugh score within12months following SBRT. Overall survival (OS), progression-free survival (PFS), and local control (LC) were calculated using the Kaplan-Meier method. The Mann-Whitney U test was used to compare two groups.
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