ESTRO 2025 - Abstract Book

S1769

Clinical – Upper GI

ESTRO 2025

Median PFS was 6.6 months. Local progression occurred in 20 patients. Deterioration of CPS >2 points from baseline in the absence of intrahepatic tumor progression occurred in 17(16.5%) patients while ALBI grade declined in 32(31.5%) patients . GI bleeding related to SBRT occurred in 4 patients. On univariate analysis better CPS, ALBI Grade, lower mean dose to uninvolved liver, higher dose to GTV was significantly associated with better OS. On multivariate analysis lower mean dose to uninvolved liver still retained significance while others did not. Conclusion: In our predominantly non-viral patient cohort, good clinical outcomes were obtained despite limited access to immunotherapy, larger tumors, high median AFP values and worse Child Pugh scores . Median OS of 13.8 months in patients with CPS A and vp4 grade macrovascular invasion far exceeds the reported survival for the same subset in the existing literature (3) . Results from our large cohort, adds to the evidence for SBRT in HCC with MVI patients more so in non-viral etiology where inferior outcomes with immunotherapy have been reported. Patients with larger tumors in terms of size and tumor volumes relative to volume of liver, than mostly reported, can be treated with comparable degree of safety using appropriately tailored dose. References: 1.Koshy, A., Devadas, K., Panackel, C. et al. Multi-center prospective survey of hepatocellular carcinoma in Kerala: More than 1,200 cases. Indian J Gastroenterol 42, 233–240 (2023). 2.NRG/RTOG 1112: Randomized Phase III Study of Sorafenib vs. Stereotactic Body Radiation Therapy (SBRT) Followed by Sorafenib in Hepatocellular Carcinoma (HCC) (NCT01730937) Dawson, L.A. et al. International Journal of Radiation Oncology, Biology, Physics, Volume 114, Issue 5, 1057 3. Breder etal IMbrave150: Exploratory efficacy and safety results of hepatocellular carcinoma (HCC) patients (pts) with main trunk and/or contralateral portal vein invasion (Vp4) treated with atezolizumab (atezo) + bevacizumab (bev) versus sorafenib (sor) in a global Ph III study Proffered Paper Improving resectability in pancreatic neoplasm (IRENE-1): a phase II trial on neoadjuvant SBRT and chemotherapy. Alessandra Arcelli 1 , Ludovica Forlani 1,2 , Alessandra Guido 1 , Federico Navarria 3 , Francesco Cellini 4 , Milly Buwenge 1 , Gabriella Macchia 5 , Francesco Deodato 4 , Savino Cilla 6 , Mariacristina Di Marco 2,7 , Giovanna Mantello 8 , Rolando D'Angelillo 9 , Silvia Cammelli 2,10 , Arina A Zamfir 1 , Claudio Ricci 2,11 , Riccardo Casadei 2,11 , Alessio G Morganti 1,2 1 Radiation Oncolgy, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 2 Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum of Bologna, Bologna, Italy. 3 Radiation Oncology Department, IRCCS Centro di Riferimento Oncologico di Aviano (CRO), Pordenone, Italy. 4 Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy. 5 Radiation Oncology Unit, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, Campobasso, Italy. 6 Medical Physics Unit, Responsible Research Hospital, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, Campobasso, Italy. 7 Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 8 Radiotherapy Department, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy. 9 Radiation Oncology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata, Roma, Italy. 10 Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 11 Division of Pancreatic Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Purpose/Objective: Current guidelines recommend neoadjuvant Stereotactic Body Radiotherapy (SBRT) combined with chemotherapy (CHT) for locally advanced pancreatic cancer (LAPC). This phase II multicenter trial aimed to assess the resectability Keywords: HCC , non-viral , SBRT 1390