ESTRO 2023 - Abstract Book

S1081

Digital Posters

ESTRO 2023

Conclusion Hypofractionated RT demonstrated promising local PVTT control with acceptable toxicity. These data suggest that 10 fraction image-guided hypofractionated RT (BED10 = 56-75 Gy10) is a feasible treatment option for PVTT in HCC patients.

PO-1349 The value of chemoradiotherapy in elderly patients with squamous cell carcinoma of the esophagus

T. Bostel 1,2 , S. Akbaba 3,2 , D. Wollschläger 4,5 , A. Mayer 3,6 , E. Nikolaidou 3,7 , M. Murnik 8,9 , S. Kirste 8,9 , A. Rühle 8,9 , A. Grosu 8,9 , J. Debus 10,11 , C. Fottner 12,2 , M. Möhler 12,7 , P. Grimminger 13,2 , H. Schmidberger 3,2 , N.H. Nicolay 8,9,14 1 University Medical Center Mainz, Department of Radiation Oncology , Mainz, Germany; 2 German Cancer Research Center (dkfz), German Cancer Consortium (DKTK) Partner Site Mainz, Heidelberg, Germany; 3 University Medical Center Mainz , Department of Radiation Oncology , Mainz , Germany; 4 University Medical Center Mainz , Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Mainz , Germany; 5 German Cancer Research Center Mainz (dkfz), German Cancer Consortium (DKTK) Partner Site Mainz, Heidelberg, Germany; 6 German Cancer Research Center Mainz , German Cancer Consortium (DKTK) Partner Site Mainz, Heidelberg, Germany; 7 German Cancer Research Center (dkfz), German Cancer Consortium (DKTK) Partner Site Mainz, Heidelberg , Germany; 8 University of Freiburg – Medical Center, Department of Radiation Oncology , Freiburg, Germany; 9 German Cancer Research Center (dkfz), German Cancer Consortium (DKTK) Partner Site Freiburg, Heidelberg, Germany; 10 University Hospital of Heidelberg, Department of Radiation Oncology , Heidelberg, Germany; 11 German Cancer Research Center (dkfz), German Cancer Consortium (DKTK) Partner Site Heidelberg, Heidelberg, Germany; 12 University Medical Center Mainz , Department of Internal Medicine I, Mainz, Germany; 13 University Medical Center Mainz , Department of General, Visceral and Transplant Surgery, Mainz , Germany; 14 University of Leipzig Medical Center, Department of Radiation Oncology , Leipzig, Germany Purpose or Objective To analyze the tolerability and outcomes of chemoradiotherapy in elderly patients with locally advanced esophageal squamous cell carcinoma (ESCC). Materials and Methods This multi-center retrospective analysis included 161 elderly patients with ESCC (median age 73 years, range 65-89 years) who were treated with definitive or neoadjuvant (chemo)radiotherapy in the period 2010 to 2019 at 3 large comprehensive cancer centers in Germany. Locoregional control (LRC), progression-free survival (PFS), distant metastasis-free survival (DMFS), overall survival (OS), and treatment-associated toxicities were analyzed, and parameters determining patient outcomes and treatment tolerance were assessed. Results Radiotherapy was delivered as initially planned to most patients (n=149, 93%). In 134 patients (83%), concomitant chemotherapy was initially prescribed; however, during the course of therapy, 41 % of these patients (n = 55) required de escalation of chemotherapy due to comorbidities and treatment-related toxicities. Fifty-two patients (32%) experienced higher-grade acute toxicities, and 22 patients (14%) higher-grade late toxicities. The 2-year LRC, DMFS, PFS, and OS rates were 67.5%, 33.8%, 31.4%, and 40.4%, respectively. On multivariate analysis, full dose concomitant chemotherapy (vs. no or modified chemotherapy) significantly improved DMFS (p=0.005), PFS (p=0.005) and OS (p=0.001). Furthermore, neoadjuvant chemoradiotherapy followed by tumor resection (vs. definitive chemoradiotherapy or definitive radiotherapy alone) was significantly associated with improved PFS (p=0.043) and OS (p=0.049). We could not identify any clinico-pathological factors significantly associated with LRC. Furthermore, definitive (chemo)radiotherapy, brachytherapy boost and stent implantation were significantly associated with higher-grade acute toxicities (p<0.001, p=0.002 and p=0.04, respectively). The incidence of higher-grade late toxicities was also significantly associated with the choice of treatment, with a higher risk for late toxicities when neoadjuvant chemoradiation was switched to definitive chemoradiation compared to definitive (chemo)radiation (p<0.001).

Conclusion