S396
Clinical - CNS
ESTRO 2026
Conclusion: Our findings underscore the central role of RT in CNS tumours and the progress made locally. The use of modern RT techniques and high treatment completion rates demonstrates the feasibility of advanced, multidisciplinary care. Integrating molecular diagnostics is an urgent priority for future progress to enhance precision diagnosis, refine individualized treatment and strengthen neuro-oncology outcomes in resource-limited settings. References: Adegboyega B, Joseph A, Alabi A, et al. Patient reported outcomes following whole brain radiotherapy in patients with brain metastases in NSIA-LUTH Cancer Center. BMC cancer. 2023;23(1):1233. Joseph A, Akinsete A, Adeneye S, et al. Feasibility and Safety of Implementing Volumetric Arc Therapy (VMAT) for Pediatric Craniospinal Irradiation in a Low-Middle-Income Region: The Nigerian Experience. Advances in Radiation Oncology. 2023;9(2):101325. Shukla I, Wang J, Guirguis M, et al. Radiotherapy and radiosurgery for intracranial lesions in Africa: Insights from 3 country case studies: A systematic review. Neuro-Oncology Advances. 2025;7(1):vdaf013-vdaf013. doi:https://doi.org/10.1093/noajnl/vdaf013 Keywords: brain tumors, radiotherapy utilization, Africa Identification of LFNG as a Novel Autonomous Predictive Gene for Resistance to Radiotherapy in Glioblastoma Patients Asmaa Naim 1 , soumya rafii 2 , amina ghouzlani 2 , dounia chraa 2 , omayma naji 2 , Abdelhakim lakhdar 3 , Abdallah badou 2 1 radiotherapy, Mohammed VI University of Health and Sciences (UM6SS), Casablanca, Morocco, casablanca, Morocco. 2 Immuno-Genetics and Human Pathology Laboratory, Faculty of Medicine and Pharmacy, University Hassan II, casablanca, Morocco. 3 neurosurgery, Ibn Rochd UHC, casablanca, Morocco Purpose/Objective: In this present study we were interested in identifying gene expression profiles that are associated with resistance to radiotherapy in human glioblastoma. Material/Methods: his study was assessed in human glioblastoma patients using 3 independent cohorts, 41 patients from The Cancer Genome Atlas (TCGA) cohort, 35 from the Chinese Glioma Genome Atlas (CGGA) cohort (Patients were stratified into two groups: group 1 included patients alive at the time of the analysis, while Group 2 comprised deceased patients.) and 28 Digital Poster 5095
patients from the Morocco cohort. Results:
Six genes, including SRPX, S100A16, LFNG, CD5, CMBL, and TCTN2 were significantly co-overexpressed in resistant versus sensitive radiotherapy-treated patients, from both the TCGA and CGGA cohorts. Among them, LFNG was identified as an independent marker for poor survival in a multivariate Cox regression analysis, accounting for established prognostic clinical parameters. High LFNG expression was associated with reduced IFN γ and increased granzyme B levels. High LFNG expression was positively correlated with four major inhibitory immune checkpoints: PD-1, PD-L1, CTLA-4, and VISTA. In contrast, it was negatively correlated with TIM-3, indicating an immunosuppressive tumor microenvironment characterized by CD8+ T cell exhaustion. Conclusion: LFNG could be an important biomarker for identifying glioblastoma patients who poorly respond to radiotherapy. Its overexpression is associated with mechanisms of immune evasion and resistance, making LFNG both an independent prognostic factor and a potential therapeutic target. If validated, LFNG expression could support patient stratification and guide the use of immunotherapy for those resistant to radiotherapy. Keywords: Glioblastoma, Radiotherapy, Immune response Digital Poster 5219 Focal conformal radiotherapy plus adjuvant chemotherapy in low-risk WNT-MB: long-term and mature outcomes from a prospective de- intensification study Tejpal Gupta 1 , Abhishek Chatterjee 1 , Archya Dasgupta 1 , Sridhar Epari 2 , Ayushi Sahay 2 , Aliasgar Moiyadi 3 , Maya Prasad 4 , Girish Chinnaswamy 4 1 Radiation Oncology, Tata Memorial Centre, Mumbai, India. 2 Pathology, Tata Memorial Centre, Mumbai, India. 3 Neurosurgery, Tata Memorial Centre, Mumbai, India. 4 Pediatric Oncology, Tata Memorial Centre, Mumbai, India Purpose/Objective: Long-term survival in wingless (WNT) pathway medulloblastoma (MB) renders it an attractive candidate for de-escalation strategies. Mature and long-term outcomes of a prospective mono- institutional clinical trial (FOR-WNT) of de-intensified radiotherapy with omission of upfront craniospinal irradiation (CSI) at index diagnosis in children with low- risk WNT-MB are presented herein.
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