S690
Clinical – Lower GI
ESTRO 2026
carcinoma (ASCC) is poorly defined. Given the treatment burden of definitive chemoradiotherapy and the established link between sarcopenia and poor outcomes in other gastrointestinal malignancies [2], we aimed to systematically evaluate the prevalence of sarcopenia in ASCC and its association with treatment- related adverse events and survival outcomes. The primary objective of this systematic review and meta- analysis was to determine the effect of sarcopenia on overall survival (OS) in patients with ASCC treated with
39 in cohort B. Median follow-up durationin cohort A was 17.3 months and 14.3 months in cohort B. The local recurrence ORR was achieved at 86.8% (46 of 53 patients) in cohort A and 76.3% (29 of 38 patients) in cohort B. The CR rate was 37.7% (20 of 53 patients) in cohort A and 26.3 % (10 of 38 patients) in cohort B. The most frequent grade 3-4 toxicities in cohort A were digestive toxicity, including: diarrhea(5.7%), nausea(5.7%), vomiting(5.7%), poor appetite(5.7%), that in cohort B were hematological toxicity, including: leukopenia(23.1%) and neutropenia(23.1%). A patient died of tumor hemorrhage after initial treatment in cohort B, which was assessed as unrelated to the therapy. Thus, the case was not included in the efficacy evaluation. Conclusion: Hypofractionated radiotherapy combined with immunochemotherapy in pMMR/MSS locally recurrent rectal cancer (LRRC) has demonstrated promising efficacy and safety. Broader evaluation of its efficacy requires validation by future studies. References: Juefeng Wan, Ruiyan Wu, Miaomiao Fu, et al. TORCH-R trial protocol: hypofractionated radiotherapy combined with chemotherapy and toripalimab for locally recurrent rectal cancer: a prospective, single- arm, two-cohort, phase II trial. Front Oncol. 2023:13:1304767. Keywords: hypofractionated, recurrent, rectal cancer Prognostic role of sarcopenia in anal squamous cell carcinoma treated with chemoradiotherapy: systematic review and meta-analysis JOANNA Socha 1,2 , Ewa Mazur 3 , Anna Dendek 3 , Adam Lizak 1,2 , Joanna Ja ś kiewicz 4 , Andrzej Doma ń ski 5 , Julia Doma ń ska 6 1 Faculty of Medicine, Jan Dlugosz University in Czestochowa, Czestochowa, Poland. 2 Department of Radiotherapy, Regional Oncology Center, Czestochowa, Poland. 3 Clinical Department of Internal Medicine and Angiology, Jan Dlugosz Univeristy in Czestochowa, Czestochowa, Poland. 4 Clinical Department of Internal Medicine and Angiology, Jan Dlugosz University in Czestochowa, Czestochowa, Poland. 5 Department of Medicine, Marshal Józef Pi ł sudski Independent Public Healthcare Complex, Plonsk, Poland. 6 Department of Medicine, Sergeant Grzegorz Za ł oga Independent Public Healthcare Institution of the Ministry of the Interior and Administration, Katowice, Poland Purpose/Objective: Sarcopenia is a recognized prognostic factor in several cancers [1], but its relevance in anal squamous cell Digital Poster Highlight 931
chemoradiotherapy. Material/Methods:
This systematic review and meta-analysis followed PRISMA 2020 guidelines. PubMed, Scopus, Google Scholar, and Cochrane CENTRAL were searched through October 2025. Eligible studies included adult patients with histologically confirmed ASCC treated with chemoradiotherapy, objective assessment of sarcopenia using imaging-based modalities, and reported survival and/or side effects outcomes. A meta-analysis was conducted according to the MOOSE guidelines, using RevMan 5.4.1. Hazard ratios (HRs) for OS and disease-free survival (DFS) were pooled using an inverse variance random-effects model. Prevalence was estimated using random-effects meta-analysis of proportions with Freeman–Tukey double arcsine transformation. Heterogeneity was quantified with the I ² statistic, and publication bias was assessed by funnel plot and Egger’s test. Adverse events outcomes were synthesized qualitatively due to heterogeneity in outcome definitions and reporting. Results: Five retrospective cohort studies (N = 426) were included (Tab.1) [3- 7].
The pooled prevalence of sarcopenia was 30% (95% CI: 21–41%). Meta-analysis showed a strong association between sarcopenia and inferior OS (HR = 2.80, 95% CI: 1.59–4.94; p = 0.0004; I ² = 0%), Fig.1.
No significant association was found for DFS (HR = 1.31, 95% CI: 0.76–2.26; p = 0.33; I ² = 0%). Sensitivity
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