S1115
Clinical – Upper GI
ESTRO 2026
Material/Methods: Between January 2017 and June 2023, 20 patients with small pNETs were treated with SBRT in a study approved by the Institutional Review Board (IRB). Primary endpoints included local control, treatment tolerance, progression-free survival (PFS), and overall survival (OS). Diagnostic work-up included endoscopy, CT scans, OctreScan or PET-Dotatoc, abdominal MRI, and histological confirmation of the tumors. Results: During a median follow-up of 42 months, SBRT was well-tolerated, with no grade >2 toxicity reported. Forty percent of patients demonstrated morphological response, while 55% remained stable. Metabolically, 50% showed significant improvement. The median OS was 41.5 months, with all patients remaining alive without evidence of local or distant progression. Only one patient underwent surgery due to a lesion detected in the liver on PET scan, which was found to
University Medical Center Groningen, Groningen, Netherlands
Purpose/Objective: Coronary artery calcification (CAC), a marker of subclinical atherosclerosis, may be associated with cardiovascular events in oesophageal cancer (EC) patients undergoing radiotherapy. This study evaluated the effect of baseline CAC on cardiovascular outcomes in this population using association models. Material/Methods: We included EC patients who received definitive or neoadjuvant (chemo)radiotherapy between 2018 and 2022, excluding those with prior coronary stents. CAC was quantified on planning computed tomography using the Agatston score (AS) [1] and categorized as high ( ≥ 300) or low (<300) [2]. Endpoints included symptomatic cardiac events (SCE) and major adverse cardiovascular events (MACE). Fine–Gray competing- risk models were applied to estimate hazard ratios (HRs) for high CAC, accounting for competing death. To estimate CAC’s effect on SCE and MACE, confounders were sequentially added and retained if they altered the CAC coefficient by >10%. Potential confounders were age, gender, cardiac history, statin use, body mass index, smoking, hypertension and diabetes. To further assess whether CAC’s effect was modified by treatment-related factors including surgery, chemotherapy, mean radiation dose to heart (MHD) and lungs (MLD), interaction terms (CAC × each treatment factor) were included. Sensitivity analyses were performed using continuous CAC modelling as log(CAC+1). Results: Four hundred fifty-four patients were included, with 196 (42.8%) presenting high CAC. Over a median follow-up of 22.1 months (46.9 months among survivors), 97 SCEs were observed. Atrial fibrillation was the most frequent event, comprising 67% of cases. High CAC was associated with an increased risk of SCE (5-year cumulative incidence 28.6% vs 15.6%; unadjusted HR 1.94, 95%CI 1.30–2.90; p < 0.01; Figure 1A). No substantial confounder was identified through sequential selection, and a post-hoc fully adjusted model yielded consistent results (HR 2.06, 95%CI 1.32– 3.22; p < 0.01). In the interaction models, the CAC effect on SCE did not differ by surgery status (p_interaction = 0.27), MHD (p_interaction = 0.96) or MLD (p_interaction = 0.64), but was suggestively stronger in the chemotherapy group (HR 2.29 [95%CI 1.50–3.51] vs. 0.72 [0.21–2.42] for non-chemotherapy; p_interaction = 0.08; Figure 2). For MACE (23 events), high CAC was associated with increased risk (HR 3.12, 95%CI 1.09–8.92; p = 0.03; Figure 1B) after adjusting for age, gender and cardiac history. Similar associations were observed in sensitivity analyses.
be a hepatic hemangioma, alongside a neuroendocrine tumor in the pancreas. Conclusion:
SBRT is a feasible and well-tolerated treatment option for small neuroendocrine tumors of the pancreas, with promising results in terms of local control. Further studies are required to validate and expand upon these findings. References: 1. Franko J, Feng W, Yip L, Genovese E, Moser AJ. Non- functional neuroendocrine carcinoma of the pancreas: incidence, tumor biology, and outcomes in 2,158 patients. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2010 Mar;14(3):541–8. 2. Halfdanarson TR, Rabe KG, Rubin J, Petersen GM. Pancreatic neuroendocrine tumors (PNETs): incidence, prognosis and recent trend toward improved survival. Ann Oncol Off J Eur Soc Med Oncol. 2008 Oct;19(10):1727– 33. 3. Hill JS, McPhee JT, McDade TP, Zhou Z, Sullivan ME, Whalen GF, et al. Pancreatic neuroendocrine tumors: the impact of surgical resection on survival. Cancer. 2009 Feb;115(4):741–51. Keywords: NEUROENDOCRINE, PANCREATIC, SBRT high coronary artery calcification is associated with cardiovascular events in oesophageal cancer patients undergoing thoracic radiotherapy Renliang Xue 1,2 , Mark L. Frederiks 1 , Arno C. Hessels 1 , Robert van der Wal 1 , Rozemarijn Vliegenthart 3 , Johannes A. Langendijk 1 , Anne G.H. Niezink 1 , Anne Crijns 1 , Robin Wijsman 1 , Christina T. Muijs 1 1 Department of Radiation Oncology, University Medical Center Groningen, Groningen, Netherlands. 2 Department of Radiation Oncology, Shantou Central Hospital, Shantou, China. 3 Department of Radiology, Digital Poster Highlight 4408
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