S799
Clinical - Lung
ESTRO 2026
Medical Center, Nijmegen, Netherlands. 4 Radiology, University Medical Center Groningen, Groningen, Netherlands. 5 Cardiology, University Medical Center Groningen, Groningen, Netherlands Purpose/Objective: Pre-treatment cardiac comorbidities are associated with post-treatment cardiac events and reduced survival in thoracic cancers. Current cardio-oncology guidelines recommend, based on expert consensus, recommend echocardiography for pre-treatment risk assessment. However, awareness and implementation of these guidelines remain limited, possibly because the clinical benefit of screening is not clear.Therefore, we aimed to (1) determine if echocardiographic screening before thoracic radiotherapy detects previously unrecognized cardiac findings requiring clinical intervention, and (2) determine which patient groups benefit most from pre-treatment screening. Material/Methods: This analysis included 279 lung and oesophageal cancer patients treated with chemoradiotherapy at the UMCG and Radboud UMC, enrolled in the CLARIFY study (NCT03978377). All patients underwent echocardiography before radiotherapy.Cardiological endpoints requiring clinical intervention were defined based on cardiology guidelines and studies (Table 1). The analysis focused only on new cardiac findings requiring clinical action; cardiac findings attributable to known pre-existing cardiac conditions were excluded. To assess the consequences of pre- treatment screening, referral, and subsequent clinical actions were recorded. Categorical variables were compared using the Pearson chi-square test, and continuous variables using either a 2-sample Student’s t-test or the Wilcoxon rank sum test, depending on normality. To identify risk factors associated with cardiac findings requiring clinical action, multivariable logistic regression with backward selection was performed.
The primary endpoint was time to next systemic therapy (TTNST), defined as the interval between the completion of SBRT and the initiation of a new systemic therapy line. Secondary endpoints included local control (LC), progression-free survival (PFS), and overall survival (OS). Univariate and multivariate analyses were performed using Cox proportional hazard regression models, with statistical significance set at p < 0.05. Results: A total of 108 patients were included, with a median age of 72 years. The majority (54.6%) had primary lung cancer, and 70.3% presented with a single lung lesion. SBRT was delivered as the primary treatment in 47.2% of cases, after first-line systemic therapy in 43.5%, and after second-line therapy in 9.3%. The median biological effective dose (BED10) was 100 Gy. No severe acute or late toxicities were observed. After a median follow-up of 20 months, the median TTNST was 24 months, with a 12-month rate of 71.2%. Median LC was 41 months, with 12- and 24-month LC rates of 87.8% and 73.6%, respectively. Median PFS was 16 months (1- and 2-year rates: 58.8% and 43.7%), and median OS was 43 months (12- and 24-month rates: 90.9% and 72.4%). Multivariate analysis showed a significant impact on TTNST for sex (p < 0.005), age (p = 0.0035), and more than one prior systemic therapy line before SBRT (p = 0.02). TTNST also significantly influenced OS (p = 0.0063, HR 0.1%), with TTNST ≥ 12 months associated with improved OS (p = 0.0037). Conclusion: SBRT represents a safe and effective therapeutic option for patients with pulmonary OMD, particularly those with limited disease burden and fewer previous systemic therapies. Early integration of SBRT into the treatment pathway can effectively postpone systemic therapy modifications and exert a favorable influence on survival outcomes. Keywords: Oligometastases, SBRT, Systemic Therapy
Poster Discussion 2690 Cardiological findings and their clinical consequences after pre-treatment echocardiographic screening in thoracic radiotherapy patients
Umut Fidan 1 , Arno C. Hessels 1 , Robin Wijsman 1 , Anthonie L. Duijnhouwer 2 , Jan Bussink 3 , Tineke P. Willems 4 , Elke S. Hoendermis 5 , Peter van der Meer 5 , Johannes A. Langendijk 1 , Christina T. Muijs 1 , Peter van Luijk 1 1 Radiation Oncology, University Medical Center Groningen, Groningen, Netherlands. 2 Cardiology, Radboud University Medical Center, Nijmegen, Netherlands. 3 Radiation Oncology, Radboud University
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