S1118
Clinical – Upper GI
ESTRO 2026
escalation through boost techniques demonstrated pronounced impact on local control. Among 6 patients who did not receive boost, 5 (83.3%) developed progression: 3 with local recurrence (60%), 1 locoregional (20%), and 1 distant (20%). Conversely, only 8/32 (25%) boost-receiving patients progressed. Median progression-free survival (PFS) was 5.6 months and median overall survival (OS) was 8.9 months. Despite clinically apparent benefit of boost delivery, no statistically significant associations were identified between failure patterns and patient characteristics, tumor factors (stage, gross tumor volume), or treatment parameters in this cohort.
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Patterns of Failure Analysis following Definitive Chemoradiation in Squamous Cell Carcinoma of the Cervical Esophagus to Guide Treatment Strategies Karun Kamboj 1 , Vaishali Kataria 1 , Hari Krishna Raju Sagiraju 2 , Aman Sharma 1 , Supriya Mallick 1 , Adhar Amrit 1 , Sibika Malla 1 , Abhilash Dagar 1 , Aditya Mehta 1 , Antara Bagchi 1 , Aarcha Ramadas 1 , Arjun Maiti 1 1 Radiation Oncology, National Cancer Institute-All India Institute of Medical Sciences, Jhajjar, India. 2 Preventive oncology, National Cancer Institute-All India Institute of Medical Sciences, Jhajjar, India Purpose/Objective: Cervical esophageal carcinoma represents a rare subset of esophageal malignancies where definitive chemoradiation (CTRT) serves as the cornerstone of management. Understanding failure patterns is critical for refining treatment strategies, optimizing radiation volumes, and identifying candidates for intensified therapy. This study aimed to characterize the temporal and spatial patterns of treatment failure following radical CTRT in these patients. Material/Methods: We retrospectively analyzed 38 patients with histologically confirmed squamous cell carcinoma of esophagus who received definitive concurrent chemoradiation between 2020-2025. The median age was 60 years (range 34-79) with male predominance (M:F=1.7:1). Most patients presented with stage III disease (78.9%). Concurrent chemotherapy was
delivered in 94.6% patients with FOLFOX (Oxaliplatin,Leucovorin,5-FU) in 71%, TP
(Pacliaxel+carboplatin) in 29% with median 3 cycles, and consolidation chemotherapy was administered in 82% of eligible patients. Radiation boost was delivered in 84.2% patients (sequential 69.7%, SIB-Simultaneoud Integrated Boost 30.3%). Elective nodal irradiation was performed in 97.4%. Treatment response was assessed at 3 months using endoscopy and PET-CT. Failure patterns were classified as local, locoregional or distant metastatic disease. Patients without post- treatment assessment (n=11) were excluded from failure analysis. Results: Among 27 evaluable patients, disease progression or death occurred in 13 cases (48.1%). Complete response was achieved in 33.3%, partial response in 33.3%, and progressive disease in 33.3%. Analysis of failure patterns revealed distant metastasis as the predominant mode:7 patients (53.8%), with lungs (n=6, 85.7%) being the most common site followed by bone(n=1, 14.2%). Local recurrence occurred in 5 patients (38.4%), while locoregional failure was documented in 1 patient (7.7%). Radiation dose
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