S1120
Clinical – Upper GI
ESTRO 2026
surgery, 10 patients underwent surgery. 50% (5/10) achieved pathological complete response (pCR). 9 patients refused surgery due to symptomatic improvement. Among those who refused surgery, 55.55% (5 /9) were disease-free on PET- CT. Progressive weight loss (2.5kg by week 5) and grade 3-4 lymphopenia (66.7%) were predominant toxicities. Nutritional support and feeding route varied among patients, with 14 patients (46.66%) maintaining oral feeding, 10 patients (33.3%) requiring feeding jejunostomy, and 6 patients (20%) needing a Ryle's tube during treatment. Analysis of feeding patterns revealed a significant shift between Week 1 and Week 5 (p=0.030). By Week 5, 16.66% of patients who initially had oral feeding required Ryle's tube insertion, indicating treatment-related dysphagia or nutritional compromise. Post-operative pneumonia occurred in 42.9% with no anastomotic leaks. Twelve-month overall survival was 43.8%. Conclusion: Conclusions: Focal dose escalation to 50 Gy using IMRT-SIB in neoadjuvant chemoradiotherapy demonstrates a promising 50% pathological complete response rate. This approach addresses the therapeutic gap for patients who may not proceed to surgery while maintaining acceptable toxicity. References: van Hagen P, Hulshof MCCM, van Lanschot JJB, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074- 84.Shapiro J, van Lanschot JJB, Hulshof MCCM, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015;16(9):1090-1098.Hulshof MCCM, Geijsen D, Rozema T, et al. A randomised controlled phase III multicenter study on dose escalation in definitive chemoradiation for patients with locally advanced esophageal cancer: ARTDECO study. J Clin Oncol. 2020;38(4_suppl):281-281. Keywords: Esophagus, Dose escalation, NACTRT Digital Poster 4786 Stereotactic body radiation therapy for liver metastases: local control and radiological response as a prognostic factor Margherita Rotondi 1 , Marco Francesco Maria Cavallaro 2 , Giuseppe Facondo 3 , Stefania Castaldo 2 , Claudio Scoglio 1 , Anna Schiattarella 1 , Enrico Raggi 1 , Olga Ionova 1 , Maria Assunta Cova 2 , Alessandro Magli 1 , Francesca Ciriello 1 1 SC Radioterapia, Azienda Sanitaria Universitaria Giuliano Isontina ASUGI, Trieste, Italy. 2 SC Radiologia, Azienda Sanitaria Universitaria Giuliano Isontina
metastatic disease. Keywords: SBRT, immunotherapy, immune response
Digital Poster 4758 Dose Escalation in Neoadjuvant
Chemoradiotherapy for Carcinoma Esophagus Using Simultaneous Integrated Boost by Intensity Modulated Radiotherapy Dr. Vatsal B Desai 1 , Dr. Nikhila Radhakrishna 1 , Dr. Nithin Bhaskar 1 , Gowtham Raj 1 , Dr. Tanvir Pasha 1 , Dr. Naveen Thimmaiah 1 , Dr. Ravi Arjunan 2 , Dr. Rajeev Lakkavalli Krishnappa 3 , Dr. Rashmi Shivananjappa 1 1 Radiation Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, India. 2 Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, India. 3 medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, India Purpose/Objective: Purpose: Standard neoadjuvant chemoradiotherapy (NACTRT) using 41.4Gy/23fractions with concurrent carboplatin-paclitaxel achieves 29% pathological complete response (pCR) in esophageal cancer(1,2). However, a subset of patients may not undergo radical esophagectomy post-NACTRT owing to poor performance status/refusal for surgery/surgical inoperability. Such patients will have a therapeutic gap after 41.4Gy, which cannot be boosted after a large gap during the waiting period for surgery. We expect that such patients might benefit from simultaneous dose escalation of the gross disease up to 50 Gy(3) during NACTRT. Whether this dose escalation will contribute to improved pathological complete response (pCR) is not yet known. Objective: To assess the impact of moderate dose-escalated NACTRT using IMRT-SIB on pathological complete response in locally advanced esophageal carcinoma. Material/Methods: Methods: This prospective single-arm study enrolled 30 patients with locally advanced squamous cell carcinoma (cT2-T3N0-1M0, age 18-70 years, ECOG 0-1). Patients received 50Gy in 25 fractions to GTV+1cm margin and 45Gy to elective volumes using IMRT-SIB, with concurrent weekly carboplatin (AUC-2) and paclitaxel (50mg/m ² ). The primary endpoint was pathological complete response rate post-surgery. Results: Results: Median age was 54 years; 63.3% were male. The median tumor length was 5.9cm. Treatment completion rate was 87% (26/30 patients) over a median treatment duration of 36 days. Median chemotherapy cycles completed were 4 (IQR 3-5). Dosimetric analysis showed excellent target coverage (PTV45: 98.93%, PTV50: 98.36%) with acceptable organ- at-risk doses. Among 26 patients, 19 were suitable for
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