SEOR- GI

Grupo de trabajo de tumores digestivos de la Sociedad Española de Oncología Radioterápica

[SEOR- GI @DigestivoSEOR]

ESTRO26: Nuevas guías de estadificacion de Cáncer de RECTO https://t.co/amDYGbh9L3

[Adriana Zucchiatti @zucchiatti_]

Gastric Cancer, A Review
https://t.co/TzcM4JNZHm
#GIpath

[Dr Rishabh Jain @DrRishabhOnco]

Concise colorectal cancer protocol by @OncBrothers

[SEOR- GI @DigestivoSEOR]

@ASTRO_org Guía de contorneo en cáncer de recto localmente avanzado #rectalcancer

[SEOR- GI @DigestivoSEOR]

5 patrones de fallo tras SBRT pancreatica. In field 2,5%, para aórticos 23,5% ,portohepatico 23,5%, AMS 17,6% y art. Celíaca 5,9%. 2.0 months. #pancreas #sbrt

[Michael Chuong @MikeChuongMD]

First patterns of failure outcomes after definitive 5-fraction ablative radiation therapy for locally advanced pancreatic cancer

I think both dose escalation & comprehensive elective coverage are key to achieving durable locoregional control

https://t.co/NvMdu8XjOh

[Raul S. Gonzalez, MD @RaulSGonzalezMD]

This is an amazing interactive pathology webinar series. Come check it out on April 16 and learn about how to apply new CAP guidelines! #pathology #gipath #pathtwitter #pathx @Pathologists

[SEOR- GI @DigestivoSEOR]

¿Cómo podemos ver la reflexión peritoneal en la RM?

[Daniel Souza @danatsouza]

Do you know how to find the anterior peritoneal reflection on MRI pelvis?

Defines intra and extra peritoneal rectum and lymphatic drainage pattern!

Look at the seagull sign on axials and others great pearls by Dr. David Kim

#SAR26 @SocietyAbdRad @SAR_RFS

[SEOR- GI @DigestivoSEOR]

Guia de contoneo de pancreas ahora en econtour.

[Dr. Nina Niu Sanford @NiuSanford]

Happy to share this interactive contouring tutorial for dose-escalated RT in locally advanced pancreas ca, which follows our NRG consensus contouring atlas.

Thank you @johnroubil, @dsouzl, @aiims2738, & the @eContourRadOnc team for working on this case!

https://t.co/oxR785IKAD

[SEOR- GI @DigestivoSEOR]

¿Cómo estamos abordando el cáncer de recto en España? 🧐
Presentamos los resultados Grupo Español de Radioterapia en Digestivo 👇
🔗 https://t.co/Hz3e7VdT4P

#RadiationOncology #GastroOnc #RectalCancer #seor

[SEOR- GI @DigestivoSEOR]

No es una comparación "limpia" de RT vs No RT:
1️⃣ Más quimio: El brazo sin RT recibió 8 ciclos de CAPOX vs 6 en el brazo de RT.
2️⃣ Selección: Son pacientes de riesgo favorable. Los casos de alto riesgo (EMVI+, T4b, MRF+) están infrarepresentados.
3️⃣ No es equivalencia

[SEOR- GI @DigestivoSEOR]

¿Podemos omitir la Radioterapia en cáncer de recto localmente avanzado? 🧠
Analizamos el ensayo CONVERT (JCO 2026): lectura crítica con las cifras que necesitas saber sobre los pacientes MRF-negativos. 👇

[SEOR- GI @DigestivoSEOR]

Menos radioterapia significa menos efectos secundarios a largo plazo:
📉 Toxicidad tardía G2–4: 16.0% (nCT) vs 26.3% (nCRT) | p=0.002
📉 Proctitis: 33.6% vs 41.7% | p=0.049
La calidad de vida a largo plazo inclina la balanza hacia la omisión selectiva.

[SEOR- GI @DigestivoSEOR]

✅ Control Locorregional (LRRFS): 97.4% (nCRT) vs 96.3% (nCT).
⚠️ Ojo: No se confirmó estadísticamente la no inferioridad para omitir la RT.
✅ Supervivencia: DFS (~89%) y OS (~95%) fueron casi idénticas en ambos brazos.

[SEOR- GI @DigestivoSEOR]

El ensayo fase III CONVERT comparó dos estrategias:
🔹 nCT: Quimio neoadyuvante (4 ciclos CAPOX) + adyuvante (4 ciclos).
🔹 nCRT: Radioquimioterapia estándar + CAPOX adyuvante (6 ciclos).
👥 Perfil: Pacientes con fascia mesorrectal libre (MRF-negativo).

[SEOR- GI @DigestivoSEOR]

📌 EBRT vs. Ablación en HCC (#ASCOGI26)
Meta-análisis (12 estudios, 2.768 pts) revela que la Radioterapia Externa supera a la ablación en:
✅ LC: HR 0.41 (p<0.0001)
✅ Recurrencia: OR 0.36 (p<0.0001)
OS y seguridad comparables.
🔗 https://t.co/zZIB9hX3Gq
#RT #HCC #OncoTwitter

[SEOR- GI @DigestivoSEOR]

CRITICS -II TNT en cáncer gástrico!

[Dr Rishabh Jain @DrRishabhOnco]

📊 CRITICS-II at #ASCOGI26

Total neoadjuvant therapy wins the pre-op race in resectable gastric cancer 🍽️🩺

3 strategies tested head-to-head
🧪 Chemo alone
🔥 Chemoradiation alone
🚀 Chemo ➜ Chemoradiation (TNT)

What stood out 👀
📈 1-yr EFS highest with TNT (84%) vs chemo (68%)
🎯 pCR doubled with TNT (20%)
⚠️ Pre-op chemo alone missed EFS efficacy threshold
🔪 Surgery quality excellent across arms, complications acceptable
💀 In-hospital mortality low (4%)

Bottom line 🧠
If the goal is deeper response + better early disease control, chemo + chemoradiation emerges as the preferred pre-operative strategy. Phase III confirmation clearly warranted.

#GI26 #ASCOGI26 #GastricCancer #Oncology
@oncoalert @larvol @asco

[Dr Rishabh Jain @DrRishabhOnco]

🚨 NEW ASTRO GUIDELINE DROP!

☢️Radiation Therapy in Gastric Cancer - What Actually Changes?

1. Resectable Disease: Where RT Fits

🔹 Perioperative chemotherapy (FLOT) = Standard
•FLOT4 ➝ FLOT > ECF/ECX
•MATTERHORN ➝ FLOT + durvalumab ↑ pCR & ↑ EFS
•KEYNOTE-585 ➝ ↑ pCR but no OS benefit with pembrolizumab
•Asian data: CLASSIC, ACTS-GC, ARTIST 2 for postop chemo

🔹 Preoperative chemoRT

Use only if:
❌ Not fit for peri-op chemo
❗ Borderline resectable (high R1/R2 risk)
🔼 Restrict to GEJ / upper & mid-stomach

Key evidence:
•TOPGEAR ➝ ↑ downstaging, ↑ pCR (17% vs 8%)
•POET, KROSG 0301, UYG-GO (supportive phase II data)

Regimen: 45 Gy/25F + 5-FU/capecitabine

🔹 Postoperative chemoRT
Use when:
•<D2 dissection → INT-0116 (Intergroup 0116)
•R1/R2
•Not fit for adjuvant multi-agent chemo

Other data:
•CALGB 80101
•ARTIST (no benefit overall; node-positive subgroup signal)

🛑 2. When Surgery Isn’t Possible

🔥 Definitive chemoRT
•For unresectable / medically inoperable / surgery-refusing
•45–50.4 Gy + 5-FU/capecitabine
•Based on prospective studies (Kim et al., Zang et al.) → ORR ~80%

❤️‍🩹 3. Palliation: RT Works Amazingly Well

🔴 Bleeding → Strong evidence

Key trials/series:
•Yoon et al., Tey et al., Kondoh et al.
•Meta-analysis by Tey et al. → bleeding response 76%

🔶 Pain & obstruction
•Response 50–100%
•Data from Lee et al., Asakura et al., Kawabata et al.

Schedules:
•8 Gy ×1
•20 Gy ×5
•30 Gy ×10

Re-irradiation supported by:
•Park et al., Lee et al. (small but effective series)

🎯 4. Oligometastatic Disease (Emerging Area)

Supporting data:
•FLOT3 (systemic therapy + MDT approach)
•Franzese et al. (SBRT series)
•Kong et al., Rauschenberg et al. (surgery/SBRT outcomes)

PET-CT + staging laparoscopy recommended before labeling as “oligometastatic.”

🧠 Takeaway
RT in gastric cancer is selective, evidence-backed, and outcome-impacting.
Right patient → big benefit.
Right setting → precise role.
Right MDT → best survival.

🔖 Save this for quick review
📖 Full guideline in comments
#OncoTwitter #GIcancer #RadOnc #MedTwitter @OncoAlert @myesmo @esmo_open @ASCO @ASTRO_org

[Alison Tree 💙 @alison_tree]

Ever wondered which patients get GU adverse events after prostate SBRT? Some pointers here

https://t.co/dQcqRXTN4O

[SEOR- GI @DigestivoSEOR]

Radiation Therapy for Gastric Cancer: An ASTRO Clinical Practice Guideline - Practical Radiation Oncology https://t.co/Dq0iy13Tlq

[Nieves Martinez Lago MD PhD @DraMartinezLago]

🔬 SABR for liver metastases
🎯 High local control, especially with small/few lesions (<6 cm, <3)
📈 Best outcomes in CRC/breast/renal
💥 BED ≥ 120 Gy = optimal control
🤏 Well-tolerated, useful for frail/unresectable pts
❓ Role vs other options unclear, RCTs needed

🔗 https://t.co/iWAZVhAPeR