ESTRO 2025 - Abstract Book

S1853

Clinical – Upper GI

ESTRO 2025

Hulshof, M. C.,et al. (2021). Randomized study on dose escalation in definitive chemoradiation for patients with locally advanced esophageal cancer (ARTDECO study). Journal of Clinical Oncology , 39 (25), 2816–2824. https://doi.org/10.1200/jco.20.03697; Cooper JS, et al. Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group. JAMA. 1999 May 5;281(17):1623-7. doi: 10.1001/jama.281.17.1623.

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Digital Poster The use of stereotactic radiotherapy in the case of recurrence of pancreatic cancer after surgery - own experience. Agnieszka Namysl-Kaletka, Iwona Debosz-Suwinska, Agata Roch-Zniszczol, Dorota Gabrys, Jerzy Wydmanski Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland Purpose/Objective: Standard treatment for pancreatic cancer is surgery; however, in approximately 30-50% of patients, there is a local recurrence of the disease. Most of these patients are not eligible for repeated surgical treatment. Systemic therapy plays an important role in extending the median survival time. Local progression of the tumour can cause many symptoms that affect the quality of life of patients, such as pain, gastrointestinal or biliary obstruction, malnutrition, and portal hypertension. Material/Methods: The study material included 20 patients. In 67% of the patients, the tumour was located in the head of the pancreas, the rest of the body, or the tail. Adenocarcinoma was the most common histopathological diagnosis (90%). 15% of the patients received adjuvant radiotherapy (two of them received 45 Gy in 25 fractions, one 40 Gy in 20 fractions). The median time from surgery to recurrence was 18.4 months (range 1.6-69.9). Stereotactic radiation therapy (SBRT) with respiratory gating, Exax-tract, Cyber Knife, and Breath hold technique was used in 9, 1, 6 and 5 patients, respectively. To reduce the risk of gastrointestinal toxicity, such as gastritis or duodenitis, ulceration, or perforation, multifraction regimens (most often 3-5 fractions) 3-15 Gy per fraction with the median total dose of 30 Gy (range 15-45 Gy) were used. Only 43% of the patients received additional chemotherapy. Results: Acute or late toxicity ≥G3 was not observed. Only in one patient, due to severe abdominal pain, the administration of the last fraction of treatment was abandoned. Three patients had stage G1 diarrhoea. In the rest of the patients, no clinically significant treatment toxicity was observed. Among the 9 patients who were under continuous control, the mean follow-up period was 15.5 months (0.63-99.7); one patient experienced local progression of the treated lesion after 1.6 months. In the remaining patients, stabilization or regression of local recurrence was observed after SBRT. The median survival time from the end of SBRT was 19 months. Conclusion: The SBRT of local recurrence of pancreatic cancer was well tolerated and effective. Thus, can be administered safely between cycles of systemic treatment. Due to the median survival time of patients, which could be attributed both to SBRT and to more effective systemic treatment, we conclude that SBRT may be an important component to improve local control and quality of life.

Keywords: recurrence, pancreatic, SBRT