ESTRO 2025 - Abstract Book

S1829

Clinical – Upper GI

ESTRO 2025

Keywords: cardiovascular risk factor, radiation toxicity

References: 1. Wang X, et al. Incidence and Onset of Severe Cardiac Events After Radiotherapy for Esophageal Cancer. J Thorac Oncol . 2020. 2. Lyon AR, et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society. Eur Heart J . 2022. 3. Golub IS, et al. Major Global Coronary Artery Calcium Guidelines. JACC Cardiovasc Imaging . 2023. 4. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J . 2021. 5. Blaha MJ, et al. Coronary Artery Calcium Scoring: Is It Time for a Change in Methodology?. JACC Cardiovasc Imaging . 2017. Proffered Paper Neoadjuvant Radio-immunotherapy for Esophageal Squamous Cell Cancer: a phase II trial Hongfu Sun, Minghao Li, Baosheng Li Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences,, Jinan, China Purpose/Objective: The safety and feasibility of neoadjuvant radio-immunotherapy (NRIT) in the treatment of with locally advanced resectable esophageal squamous cell cancer (ESCC) has been demonstrated in our prior phase Ib clinical trial (PMID:38181839, 22 patients). To further assess the efficacy of NRIT, we expand the phase Ib trial to the current phase II study (ChiCTR1900022282). Material/Methods: The study enrolled patients with newly diagnosed locally advanced, resectable ESCC (clinical stages: T3-4N0M0/T1 4N+M0, according to the 8th AJCC staging system). Participants received radiotherapy (RT) at a dose of 41.4 Gy in 23 fractions using intensity modulated radiotherapy (IMRT), along with four cycles of toripalimab (240mg, every three weeks). Surgery was scheduled within 7-8 weeks following the completion of RT. The primary endpoint was pathological complete response (pCR). Results: Between October 2019 and November 2023, 56 patients were enrolled, including 48 males and 8 females. A total of 47 patients (83.9%) underwent radical surgery, with an R0 resection rate of 100% (47/47). The pCR and major pathological response (MPR) rates were 36.2% (17/47) and 51.1% (24/47), respectively. The median overall survival (OS) was not reached, with one-year and two-year OS rates of 89.3% and 76.3%, respectively. The median disease free survival (DFS) was 32.66 months, with corresponding one-year and two-year DFS rates of 66.0% and 54.0%, respectively. The common treatment-related adverse events (TRAEs) were grade 1 or 2. Severe TRAEs mainly included anastomotic leaks in 4 cases, grade 3 alanine aminotransferase level and grade 3 myocarditis in 1 case and lung infection after surgery in 2 cases. Conclusion: The NRIT regimen has an encouraging treatment efficacy in patients with locally advanced resectable ESCC, and warrants further study in a larger cohort. 3438

Keywords: Esophageal cancer; Neoadjuvant Immunotherapy