S1141
Clinical - Urology
ESTRO 2026
patients with UTUC treated with definitive IMRT between 2016 and 2024. All patients were either medically inoperable or refused surgery due to advanced age or comorbidities. All tumors were located in the ureter (100%), with no cases involving the renal pelvis. The median prescribed dose was 60 Gy (range, 54–66 Gy) in 30 fractions. Radiotherapy was delivered to the primary tumor only, without prophylactic lymph node irradiation, and no concurrent chemotherapy was administered.Endpoints included overall survival (OS), disease-specific survival (DSS), local control (LC), distant metastasis-free survival (DMFS), and progression-free survival (PFS). Adverse events were graded according to CTCAE v5.0. Survival curves were estimated using the Kaplan–Meier method, and outcomes were compared between patients who received <60 Gy vs. ≥ 60 Gy using the log-rank test. Results: The median age was 82 years (range, 70–88), and the median follow-up was 26 months (range, 2– 126).Nineteen patients (82.6%) had histologically confirmed urothelial carcinoma, while four were diagnosed radiographically. At last follow-up, 7 patients (30.4%) had died of disease, 4 (17.4%) had died of other causes, and 12 (52.2%) were alive. Local failure occurred in 6 patients, distant metastasis in 2, and both in 3. The 2-year OS, DSS, LC, DMFS, and PFS rates were 67.2%, 74.0%, 60.0%, 76.5%, and 53.8%, respectively. Patients who received ≥ 60 Gy showed significantly better OS (p<0.01), DSS (p=0.02), and DMFS (p=0.04) than those who received ≤ 60 Gy. Grade ≥ 3 genitourinary adverse events (hematuria) occurred in 2 patients (8%), and no gastrointestinal adverse events ≥ grade 2 were observed.
Conclusion: This is one of the most extensive series evaluating the clinical outcomes of UTUC treated with definitive IMRT. The treatment achieved favorable survival outcomes and acceptable side effects, even in an elderly and medically inoperable population. A radiation dose >60 Gy may improve survival outcomes. IMRT could be considered a feasible and effective non-surgical treatment option for patients unsuitable for surgery. Keywords: Urothelial carcinoma, Upper urinary tract, IMRT Digital Poster Highlight 476 PSMA PET-positive local recurrences in the prostate bed region and their coverage based on clinical target volume delineation guidelines Erik Moar 1 , Michael Keilholz 1 , Gabriel T Sheikh 2 , Rudolf Werner 2 , Christian Trapp 1 , Jozefina Casuscelli 3 , Frederike Brose 1 , Chukwuka Eze 1 , Franziska Walter 1 , Claus Belka 1,4 , Minglun Li 1,5 , Paul Rogowski 1 , Nina- Sophie Schmidt-Hegemann 1 1 Department of Radiation Oncology, LMU University Hospital, Munich, Germany. 2 Department of Nuclear Medicine, LMU University Hospital, Munich, Germany. 3 Department of Urology, LMU University Hospital, Munich, Germany. 4 German Cancer Consortium, DKTK, Heidelberg, Germany. 5 Department of Radiation Oncology, Lueneburg Hospital, Lueneburg, Germany
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