ESTRO 2025 - Abstract Book

S1783

Clinical – Upper GI

ESTRO 2025

Figure 1. Study Selection Process. Conclusion:

The evidence concerning MRI use for target volume delineation in gastric cancer radiotherapy planning is very limited. The superior contrast resolution of MRI sequences to differentiate malignant tumour from background stomach is well described, but this has not yet been translated to radiotherapy planning. Further research investigating MRI to plan radiotherapy for gastric cancer patients would address this gap in clinical knowledge.

Keywords: gastric, radiotherapy, MRI

References: 1. Zhang Y, Yu J. The role of MRI in the diagnosis and treatment of gastric cancer. Diagn Interv Radiol. 2020;26(3):176-82. 2. Huang Z, Xie DH, Guo L, et al. The utility of MRI for pre-operative T and N staging of gastric carcinoma: a systematic review and meta-analysis. Br J Radiol. 2015;88(1050):20140552. 3. Leong T, Smithers BM, Michael M, et al. Preoperative Chemoradiotherapy for Resectable Gastric Cancer. N Engl J Med. 2024. doi: 10.1056/NEJMoa2405195.

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Mini-Oral Clinical outcomes from EMERALD trial: A phase I evaluating ultra-hypofractionated MR-Guided Adaptive SABR (SMART) for localized pancreatic cancer. Somnath Mukherjee 1,2,3 , Elena Moreno-Olmedo 3 , Suliana Teoh 2 , Lynda Swan 4 , Alexander Ooms 5 , M.Sofia Massa 5 , Yu Qiao 5 , Ben George 6 , Killian Nugent 3 , Stephanie Levy 4 , Robert Owens 1,3 , Ami Sabharwal 1,3 , Philip Camilleri 1,3,2 , Maxwell Robinson 7 , James Good 3 , Timothy Maughan 2,8,1 1 Oncology, Oxford University Hospital NHS Trust, Oxford, United Kingdom. 2 Oncology, Oxford University, Oxford, United Kingdom. 3 Oncology, Genesiscare, United Kingdom, Oxford, United Kingdom. 4 Oxford Clinical Trials Office, Oxford University, Oxford, United Kingdom. 5 Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedis, Rheumatology and MSK Sciences, University of Oxford, Oxford, United Kingdom. 6 Radiotherapy Physics, Genesiscare, United Kingdom, Oxford, United Kingdom. 7 Radiotherapy Physics, Oxford University Hospital NHS Trust, Oxford, United Kingdom. 8 Oncology, University of Liverpool, Liverpool, United Kingdom Purpose/Objective: Stereotactic magnetic resonance-guided radiotherapy (SMART) allows delivery of high dose SABR in 5 fractions to the pancreas, but it is resources intensive. EMERALD evaluated the feasibility and safety of ultra-hypofractionated SMART in localised pancreatic cancer (PDAC), using three and single fraction schedules Material/Methods: This is a single-centre, three-arm, phase 1 non-randomised safety study (1). Patients with localised or locally recurrent PDAC received SMART either 50 Gy/5 (Level1; BED 10 100 Gy), 39 Gy/3 (Level2; BED 10 90 Gy) or 25 Gy/1 fraction (Level3; BED 10 87.5 Gy). Each of the arms was assessed as independent cohort. The primary end-point was Dose-limiting toxicity (DLT) occurring within 3 months of SMART [defined as G3 upper GI bleeding, any grade of GI fistula, G4 nausea/vomiting, G4 pancreatitis and non-tumour-related vascular events] . Secondary endpoints included any other acute and late toxicity, local control (LC), local progression free survival (LPFS) and overall survival (OS). The study was approved by West Midlands-Black Country Research Ethics committee, sponsored by Oxford University, funded by Oxford University-Genesiscare collaboration fund, the John Black Charitable foundation and Oxford Institute of Radiation Oncology. The trial was administered through the Oxford Clinical Trials Office. Trial registration number: ISRCTN10557832 .