Cone-beam computed tomography-based online adaptive radiotherapy of esophageal cancer in the neoadjuvant setting: Dosimetric analysis, toxicity and treatment response.

Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Published Date: Jun 6, 2025

Abstract

BACKGROUND AND PURPOSE: Chemoradiotherapy (CRT) followed by surgery is a treatment option for esophageal cancer (EC). However, concerns persist regarding cardiopulmonary toxicity and inconsistent daily target coverage due to anatomical changes. To address these challenges, we implemented a CBCT-based online adaptive radiotherapy (oART) workflow for EC. This study provides updated dosimetric results and evaluates toxicity and treatment response using daily oART on the Ethos™ platform for EC in the neoadjuvant setting.

Authors

  • Nicolas Bachmann
    Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Maiwand Ahmadsei
    Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland.
  • Moritz Hürlimann
    Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Hubert S Gabrys
    Department of Radiation Oncology, Zurich University Hospital, University of Zurich, Zurich, Switzerland.
  • Daniel Schmidhalter
    Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Jenny Bertholet
    Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Switzerland.
  • Martin D Berger
    Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Yves Borbély
    Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Ekin Ermiş
    Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
  • Emanuel Stutz
    Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Binaya K Shrestha
    Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Daniel M Aebersold
    Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
  • Peter Manser
    Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
  • Hossein Hemmatazad
    Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.

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