S2694
RTT - Patient preparation, immobilisation, and verification protocols
ESTRO 2026
toxicityFrequency and urgency were highest at 6 weeks, showing the steepest declines within the first year.Nocturia remained relatively stable across the follow - up period, affecting a subset of patients persistently.Incontinence was infrequent overall but most common early after treatment.Repeated Measures ANOVA:Bowel symptoms – Only diarrhoea demonstrated a statistically significant change over time (p = 0.006).Bladder symptoms – Reductions in frequency and urgency approached significance but were not statistically significant (p > 0.05), potentially due to inter - patient variability and smaller numbers at later follow - up points Conclusion: To conclude GI & GU toxicity remains stable and inline with previously reported figures (Chetiyawardana et al 2020), demonstrating that it is safe and effective to treat patients having prostate radiotherapy with an empty bladder. References: Chetiyawardana G, Hoskin PJ, Tsang YM. The implementation of an empty bladder filling protocol for localised prostate volumetric modulated arctherapy (VMAT): early results of a single institution service evaluation. Br J Radiol. 2020 Oct 1;93(1114):20200548. doi: 10.1259/bjr.20200548. Epub 2020 Jul 31. PMID: 32706990; PMCID: PMC7548355. Keywords: Toxcicity, Empty Bladder, Prostate Digital Poster 119 Rectal spacers in prostate radiotherapy: systematic review and meta-analysis of efficacy and safety KA LUN CHUI Urology, Dr Chui Ka Lun's Clinic, Hong Kong, Hong Kong Purpose/Objective: Rectal toxicity remains a significant concern in prostate cancer radiotherapy. This systematic review and meta-analysis evaluated the efficacy and safety of rectal spacers in reducing radiation-induced rectal toxicity and improving patient outcomes. Material/Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, and Cochrane databases through September 2025 for studies comparing prostate radiotherapy with and without rectal spacers. Inclusion criteria encompassed randomized controlled trials (RCTs) and observational studies reporting dosimetric parameters, toxicity outcomes, or quality of life measures. Study quality was assessed using Cochrane RoB 2 for RCTs and Newcastle-Ottawa Scale for observational studies. Random-effects meta-
scanning in head and neck cancer radiotherapy: A feasibility study. Phys Imaging Radiat Oncol. 2024;29:100563. 3. Wei W, et al. Quantifying the impact of optical surface guidance in the treatment of cancers of the head and neck. J Appl Clin Med Phys. 2020;21(6):73–82. 4. Zhao B, et al. Minimal mask immobilization with optical surface guidance for head and neck radiotherapy. J Appl Clin Med Phys. 2018;19(1):17–24. Keywords: Set-up accuracy, Dose Delivery, DSPS Prominent Analysis of GI and GU toxicity over 5 Years follow up for a centre doing empty bladder prostate radiotherapy for 10 years. Roeum Butt, Sara Downing, Danie Megias Radiotherapy, Mount Vernon Cancer Centre, London, United Kingdom Purpose/Objective: To evaluate bowel and bladder toxicity over a 5 - year follow - up period in patients treated with radiotherapy to the prostate with an empty bladder, using prospectively collected patient - reported outcome measures (PROMs) collected by clinic radiographers using the CTCAE V5 scoring system. Material/Methods: Digital Poster 56 PROM data were collected at 6 weeks, 6 months, 1 year, 2 years, 3 years, and 5 years post - treatment. Each time point included two questionnaires: one focusing on bowel function and one on bladder function.Questionnaires assessed symptom presence, frequency, and severity, including:Bowel domains – pain on opening bowels, diarrhoea, urgency, incontinence, bleeding, constipation, stool consistency, and impact on daily life.Bladder domains – frequency, urgency, nocturia, incontinence, dysuria, haematuria, and urgency incontinence.Responses were coded numerically for analysis.Statistical analysis:Descriptive statistics were calculated for each symptom and time point, expressed as mean scores (0–3 scale) to one decimal place.Repeated measures ANOVA was performed for each symptom to test changes over time. Results: Descriptive findings:Bowel toxicityConstipation was the most prevalent bowel symptom, peaking at 2 years (mean 0.16) before declining slightly at 5 years (mean 0.13).Rectal bleeding increased gradually from 6 months (0.06) to 3 years (0.12) and remained stable at 5 years (0.11).Pain on opening bowels was consistently low (<0.05 at all time points).Diarrhoea declined from 0.04 at 6 weeks to 0.00 at 5 years.Bladder
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