S800
Clinical - Lung
ESTRO 2026
Results: A total of 19 (6.8%) new cardiologic findings were observed, while 76 patients had pre-existing cardiac comorbidity. Patient characteristics are described in Table 2. Patients with cardiac findings requiring clinical intervention were more likely to be older (11.5% vs. 2.1%), and to have pre-existing cardiac comorbidities (15.8% vs. 3.4%) (Table 2). Among 203 patients without pre-existing cardiovascular comorbidities, echocardiography identified new cardiac findings in 7 patients (3.4%), all of whom were referred to a cardiologist. In contrast, 12 out of 76 patients (15.8%) with known cardiovascular comorbidities presented with new cardiac findings. Of these, 7 patients (9.2%) were referred to the cardiologist, although all were already under cardiac surveillance.. Five were not referred despite new findings. In the 14 referred patients, 7 required treatment including pericardiocentesis, anti-hypertensive and anti- arrhythmic treatments. In 3 patients, cardiological follow-up was deemed sufficient, while 4 patients required no further action.
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Minimizing Esophagitis in Locoregionally Advanced NSCLC Receiving Consolidation Hypofractionated Thoracic Radiotherapy Following Chemoimmunotherapy Caglayan Selenge Beduk Esen 1 , Sukran Senyurek 2 , Duygu Sezen 2 , Yucel Saglam 1 , Ali Ihsan Atasoy 1 , Fatih Karakose 2 , Mustafa Budak 2 , Mustafa Tintas 2 , Mustafa Buyukkose 1 , Nulifer Kilic Durankus 2 , Saliha Ezgi Oymak 1 , Yasemin Atagun 1,2 , Ugur Selek 1,2 1 Department of Radiation Oncology, American Hospital, Istanbul, Turkey. 2 Department of Radiation Oncology, Koc University Faculty of Medicine, Istanbul, Turkey Purpose/Objective: To assess the incidence and predictors of esophagitis among patients with non-small cell lung cancer (NSCLC) undergoing induction chemoimmunotherapy, consolidative definitive hypofractionated thoracic radiotherapy (RT) and subsequent maintenance immunotherapy. Material/Methods: This retrospective study included 68 patients with stage IIB–IVB NSCLC treated between 2019 and 2025. All patients underwent four-dimensional CT simulation, and target volumes were contoured on the average respiratory phase, incorporating motion across all phases. Consolidative RT was delivered using simultaneous-integrated boost (SIB) intensity- modulated RT (IMRT). Lung dose evaluation was based on the expiratory phase (V50), while esophageal doses were calculated using an integrated volume across the respiratory cycle. The primary endpoint was the incidence of esophagitis; secondary endpoints included predictors of esophagitis in the immunotherapy era. Results: Median age was 67 years (range: 33–80). Median albumin and pan-immune-inflammation-value were 41.7 g/L and 510, respectively. The most common regimen was carboplatin–paclitaxel (68%) and pembrolizumab (47%). Patients received a median of 4 chemotherapy (range: 2–7) and 4 immunotherapy (range: 1–10) induction cycles; 27 patients (40%) received concomitant immunotherapy. The median prescribed RT dose was 52.5 Gy (range: 45–60) in 15 fractions. Radiation-related esophagitis occurred in 46 patients (68%), including grade 1, 2, and 3 in 15%, 47%, and 6%, respectively; no grade 4–5 events occurred. Younger age, fewer induction chemotherapy cycles, more advanced stage, higher esophageal Dmean, and higher V30 were significantly associated with grade ≥ 2 esophagitis (Table 1). None of the evaluated clinical or dosimetric parameters significantly predicted grade ≥ 3 esophagitis, likely due to the low number of severe
Conclusion: Cardiac abnormalities were detected in over 10% of patients with risk factors, such as advanced age and existing cardiac comorbidity. These findings frequently required clinical intervention, including treatment or close monitoring. Therefore, pre-treatment cardiac screening is particularly warranted in patients with these risk factors. Keywords: Cardiac comorbidities, screening, risk assessment
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