S1138
Clinical - Urology
ESTRO 2026
Europea de Madrid, Madrid, Spain. 6 Department of Veterinary Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain. 7 Department of Radiation Oncology, Centro 360 de ExcelenciaOncológica GCCC, Barcelona, Barcelona, Spain. 8 Department of Radiation Oncology, GenesisCare Córdoba, Córdoba, Spain. 9 Department of Radiation Oncology, GenesisCare Guadalajara, Guadalajara, Spain. 10 Department of Radiation Oncology, GenesisCare Madrid, Madrid, Spain. 11 Department of Radiation Oncology, GenesisCare Alcázar de San Juan, Alcázar de San Juan, Spain. 12 Department of Radiation Oncology, GenesisCare Málaga, Málaga, Spain. 13 Department of Radiation Oncology, GenesisCare Sevilla, Sevilla, Spain. 14 Department of Radiation Oncology, GenesisCare Jerez de la Frontera, Jerez de la Frontera, Spain. 15 Department of Radiation Oncology, GenesisCare Campo de Gibraltar, Algeciras, Spain. 16 Department of Radiation Oncology, GenesisCare Alicante, Alicante, Spain. 17 Department of Radiation Oncology, GenesisCare Hospital Vithas Valencia Consuelo, Valencia, Spain. 18 Department of Medical Oncology, GenesisCare Hospital Universitario San Francisco de Asís, Madrid, Spain Purpose/Objective: Stereotactic body radiotherapy (SBRT) has become an established therapeutic option for localized prostate cancer. However, long-term data from real-world clinical practice remain limited. This study aimed to evaluate two-year biochemical control, radiological progression, and late toxicity in a multicenter Spanish cohort treated with SBRT under standardized planning and daily image-guided conditions. Material/Methods: A total of 250 patients with localized prostate cancer were treated with SBRT between January 2020 and December 2023 in 12 centers across Spain. Prescribed doses ranged from 36.25 to 40 Gy in five fractions. Genitourinary (GU), gastrointestinal (GI), and sexual toxicities were assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Biochemical recurrence was defined by the Phoenix criterion (PSA nadir + 2 ng/mL), and radiological progression was determined by imaging studies (MRI, CT, or PSMA PET/CT). Results: The median age was 72 years, and the median baseline PSA was 6.7 ng/mL. According to NCCN risk classification, 4.0% of patients had very low risk, 26.4% low, 66.4% intermediate (26.8% favorable; 39.6% unfavorable), 2.8% high, and 0.4% very high risk. Androgen deprivation therapy (ADT) was used in 33.5% of patients (30.3% short-term ≤ 6 months; 3.2% long-term >6 months). At 24 months of follow-up, biochemical control was 96.4%, and radiological
progression occurred in 2.8% (mainly nodal). No bone or visceral recurrences were observed. Rectal spacers were used in 99.2% of patients (Barrigel 58.9%; SpaceOAR 41.1%). Late grade ≥ 2 toxicities were reported in 7.6% GU, 1.2% GI, and 14.2% sexual categories.
Conclusion: This multicenter study demonstrates that prostate SBRT achieves excellent two-year oncological outcomes and maintains a favorable long-term side- effect profile, reaffirming its role as a safe, effective, and reproducible treatment for localized prostate cancer. A further step toward shorter and more precise radiotherapy schedules in real-world clinical practice. References: Widmark A, Gunnlaugsson A, Beckman L, et al. Ultra- hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: 5 year outcomes of the HYPO-RT-PC trial. Lancet. 2019;394:385–395.Tree AC, Alexander EJ, van As NJ, et al. Stereotactic body radiotherapy versus conventionally fractionated radiotherapy for prostate cancer (PACE-B): primary results of a randomised phase 3 trial. Lancet Oncol. 2022;23:1308–1320. Keywords: Prostate cancer, Stereotactic body radiotherapy
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