S1129
Clinical - Urology
ESTRO 2026
radiotherapy is directly relevant to your topic and published in Lancet Oncol, a leading journal in oncology. This reference is highly suitable. Keywords: Hypofractionated Radiotherapy, Prostate Cancer,
locally advanced prostate cancer treated with HFRT and androgen deprivation therapy (ADT). Material/Methods: A retrospective analysis was conducted on 183 patients with locally advanced, biopsy-confirmed high- risk prostate cancer (T2b–T4 and/or N1, M0; Gleason Score ≥ 4+4; PSA>20ng/ml) who underwent HFRT and ADT between 2011 and 2020. Radiotherapy was applied to the prostate and regional lymphatics using the simultaneous integrated boost (SIB) and volumetric moduleted arc therapy (VMAT) technique. Radiotherapy was administered in 33 fractions, with a total of 73 Gy to the prostate and seminal vesicles, 60 Gy to the obturator and external iliac lymph nodes, and 54 Gy to the common iliac nodes up-to the bifurcation level. 66 Gy was applied to the tumor- involved lymph nodes. ADT was started 4 months before radiotherapy as neoadjuvant and was applied for a total of 36 months. The effects of PSA value and PSA nadir on survival on the 40th day after starting ADT were examined. Survival outcomes, including overall survival (OS), clinical failure-free survival (CFFS), biochemical recurrence-free survival (BFFS), and metastasis-free survival (MFS), were analyzed using Kaplan–Meier estimates and Cox proportional hazards models. Results: The mean age of the patients in the study was 70.61.During a median follow-up of 62.63 months, the mean survival outcomes were as follows: Overall survival;121.5 m, CFFS;140.3 m, BFFS;143.1 m, MFS; 145.5 months. 10-year OS, CFFS, BFFS, and MFS rates were 64%, 81.7%, 83.6%, and 85.2%, respectively. The median PSA value on the 40th day after starting ADT was 0.02 ng/ml (.00-24.78), and the median PSA nadir value was .000 (.00-11,08). A significant PSA reduction by day 40 was independently associated with improved OS (HR: 1.81, p = 0.046), CFFS (HR: 2.52, p = 0.003), MFS (HR: 4.78, p = 0.001), and BFFS (OR: 0.19, p < 0.001). Higher ISUP grade was also a strong independent predictor of adverse clinical outcomes. Conclusion: Early PSA kinetics and ISUP grade are independent prognostic markers in high-risk locally advanced prostate cancer patients treated with HFRT plus ADT. Moderate HFRT with ADT offers a well-tolerated, effective therapeutic option for high-risk patients. References: Dearnaley et al., 2016: This study from the CHHiP trial is highly relevant and well-known in radiation oncology circles. Published in Lancet Oncol, a top-tier journal, it is appropriate for citation.Wilson et al., 2018: This paper focuses on a subgroup analysis from the CHHiP trial, and Int J Radiat Oncol Biol Phys is a premier journal in the field. This reference is highly appropriate.Incrocci et al., 2016: The HYPRO trial comparing hypofractionated versus conventional
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Preventive effect of daikenchuto on Incidence of rectal bleeding after IMRT for prostate cancer Masateru Fujiwara 1 , Kazuhiko Hayashi 2,1 , Jiro Nakayama 3 , Hitoya Ota 1 , Kazuhiko Ogawa 2,1 1 Radiation Oncology, Suita Tokushu-kai Hospital, Suita, Japan. 2 Radiation Oncology, Osaka University, Suita, Japan. 3 Urology, Osaka Rosai Hospital, Sakai, Japan Purpose/Objective: Rectal bleeding due to radiation proctitis after treatment in radiation therapy for prostate cancer is a typical late toxicity symptom. The rectal bleeding rate has been reduced by using IMRT, IGRT and peri-rectal hydrogel spacer. On the other hand, few reports have attempted to reduce the rate of rectal bleeding by medication. It has been reported that daikenchuto (DKT), a traditional Japanese herbal medicine, has the effects of improving intestinal blood flow and anti- fibrosis.[1,2] The purpose of this study was to evaluate the reduction of rectal bleeding rate by administering DKT. Material/Methods: A total of 113 patients who treated IMRT for prostate cancer without the placement of peri-rectal hydrogel spacer in the retrospective analysis. Fifty-four patients (48%) in the DKT group concurrently administered DKT at 10 g or 15 g per day starting 1 month before IMRT and continuing over 3 months after completion of IMRT. The irradiation was carried out, confirming the rectal volume every time by the IGRT using cone beam CT in all cases. Dose fractionation was 70 Gy in 28 fractions (61%) or 78 Gy in 39 fractions (39%). The cumulative rectal bleeding rate based on CTCAE v5.0 was used to compare the DKT and control groups. The Kaplan-Meier method was used for the cumulative rectal bleeding rate, and the COX hazard model was used for risk factors. In addition, propensity score matching (PSM) was performed to adjust for the balance of background information. Results: The median observation period for the DKT and control groups was 48 (21-110) and 61 (17-125) months, respectively. In the DKT group, Grade 1 rectal bleeding was 4% and Grade 2 or higher was not observed. In the control group, the Grade 1 was 22%, Grade 2 was 10%, and Grade 3 or higher was not observed. In univariate analysis, DKT administration, dose fractionation and planned rectal doses (V40, V50,
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