S1112
Clinical – Upper GI
ESTRO 2026
baseline, 3, 6, 12 and 24 months post-SBRT. Results: From February 2019 to August 2025, 169 patients were enrolled and treated at a single institution. Eight patients (4.7%) did not complete all planned fractions, but were included in the analysis. The baseline characteristics are shown in table 1. The median follow-up time from SBRT was 23.1 months (95% CI, 17.5-44.6). Median OS from SBRT to death from any cause was 13.9 months (95% CI, 10.9-15.9; range 0.7- 69.7) with a one-year survival probability of 53% (95% CI, 46%-62%) (Figure 1). Data on disease progression was available for 147 patients (87.0%). Median PFS from SBRT to progression of any kind was 7.8 months (95% CI, 6.2-11.56) and one-year PFS was 38.8% (95% CI, 31.0-48.4%). Median FFLP from SBRT to local progression was 28.7 months (95% CI, 16.8-upper bound missing) and one-year FFLP was 73.8% (95% CI, 64.6%-84.2%).Gastrointestinal toxicity at 3-month follow-up was assessed in 104 patients: one patient developed grade III diarrhea, while one patient experienced grade IV ulcer perforation, and another had a grade V duodenal perforation (both potentially radiotherapy-related). No grade ≥ III events were observed at later follow-up points.
Conclusion: Adaptive SBRT for pancreatic cancer is well tolerated and yields promising overall survival and local control. The slightly lower one-year survival compared to a previous study(4) may reflect an older cohort, inclusion of patients with ECOG performance status 2, and inclusion of patients with local recurrence, who were excluded in the prior trial. References: 1. Weisz Ejlsmark M et al: Adaptive MRI-guided stereotactic body radiation therapy for locally advanced pancreatic cancer - A phase II study. Radiother Oncol 197:110347, 20242. de Mol van Otterloo SR et al: The MOMENTUM Study: An International Registry for the Evidence-Based Introduction of MR-Guided Adaptive Therapy. Front Oncol 10:1328, 20203. Schemper M et al.: A note on quantifying follow-up in studies of failure time. Controlled Clinical Trials 17:343-346, 19964. Parikh PJ et al: A Multi-Institutional Phase 2 Trial of Ablative 5- Fraction Stereotactic Magnetic Resonance-Guided On- Table Adaptive Radiation Therapy for Borderline Resectable and Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 117:799-808, 2023 Keywords: Pancreatic cancer, overall survival Digital Poster 4208 Clinical Feasibility of a Hybrid Radiotherapy Strategy for Esophageal Cancer Using Conventional Delivery and an MR-Linac Adaptive Boost Teo Stanescu 1,2 , Oleksii Semeniuk 1 , Andrea Shessel 3 , Ali Hosni 3,2 , Jelena Lukovic 3,2 , John Kim 3,2 , Rebecca Wong 3,2 1 Medical Physics, Princess Margaret Cancer Centre, Toronto, Canada. 2 Radiation Oncology, University of
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