S1147
Clinical - Urology
ESTRO 2026
genitourinary (GU) and gastrointestinal (GI) adverse side effects captured as patient- (PROs) and clinician- reported outcomes (CROs) in a prospective real-world setting. Material/Methods: We prospectively collected data from 176 and 62 patients receiving WPRT and PORT for primary prostate cancer, respectively (NCT05224297). The prescribed dose to the PTV was moderately hypofractionated with 20x3Gy to the prostate and 20x2.3Gy to the pelvic nodes, if applicable. Patients completed GU/GI PRO questionnaires (PRO-CTCAE- items: GU = 61a, 62a, 62b, 63a, 63b, + weak urine stream / incomplete bladder emptying; GI = 13a, 13b, 15a, 16a) weekly during therapy and after 3, 12, 24 months post-treatment. The maximum scores over PRO sub-questions were subsequently averaged to obtain an aggregated score for GU and GI symptoms. Complementary, CROs were documented as GU and GI RTOG scores during therapy and at scheduled follow-up appointments. We compared PRO and CRO scores between cohorts using the Mann-Whitney-U- Test (significance level =0.013) at time points tmax (maximum score during treatment) and 3, 12, and 24 months after treatment. ROC-curve analysis was performed for each time point individually to investigate the discriminatory ability of the composite PRO score for RTOG grade =0 and ≥ 1. AUCs were resampled one thousand times. Results: WPRT patients had significantly higher acute (tmax) composite GI PRO scores (p=0.010), while acute GI CRO differences were not significant (p=0.014) as shown in Figure 1. For other time points, differences were also not significant. CRO cumulative late ( ≥ 12m) adverse GU event prevalence (RTOG ≥ 2) was 18.8% for PORT, and 10.0% for WPRT, and 4.2% versus 2.3% for GI-events (p ≥ 0.121). The AUCs for GU-events were identified as significant (p<0.0001) with values of 0.76, 0.80, 0.77, and 0.84. Discrimination of GI events was possible with AUCs of 0.71(p<0.0001), 0.73(p<0.0001), 0.70(p<0.0001), and 0.59(p=0.3106) for the four time points, respectively (Figure 2).
gel, and fiducial markers. Each patient then received SAbR, with a total dose of 4000 cGy delivered in 5 fractions to the prostate and proximal seminal vesicles. In the present analysis, we used descriptive statistics to summarize patient-reported health related quality of life metrics (including AUA symptom score), and uroflowmetry results. Results: Among the participants, the distribution of biopsy Gleason score of 3+4, and 4+3 were 14 (93.3%), and 1 (6.7%). The median initial PSA was 7.13 ng/mL (IQR 5.9- 9.3). At the time of this analysis, all patients had completed the study interventions and presented for 90-day post-SAbR follow-up. The peak urinary flow rate at baseline and 3-month post-radiation were median 10.4 [IQR 7.23 -16.28] mL/s and 12.45 [9.38- 17.28] mL/s (p=0.54, Wilcoxon signed-rank test). The time to peak urinary flow rate at baseline and 3-month post-radiation were median 10.1 [IQR 4.6-19.05] s and 5.55 [4.55-7] s (p=0.0.29). The median AUA symptom score was 21 [IQR 20-24] baseline and 14 [IQR 9.5-16] 3-months post-SAbR (p=0.001), respectively. Conclusion: PUL with spacer gel, followed by SAbR, appears to be a safe and feasible strategy for PCa patients with underlying BPH, with objective and patient-reported improvement in LUTS 3-months post-SAbR. Long-term follow-up is ongoing. Keywords: prostate cancer, benign prostate hyperplasia Poster Discussion 589 Patient- and Clinician-Reported adverse events in primary Prostate Only and Whole Pelvis Moderately Hypofractionated Prostate Radiotherapy Leo Andexlinger 1,2 , Barbara Knäusl 1,2 , Maximilian Schmid 1,2 , Andreas Renner 1,2 , Joachim Widder 1,2 , Gregor Goldner 2 , Gerd Heilemann 1,2 1 Christian Doppler Laboratory for Image and Knowledge Driven Precision Radiation Oncology, Medical University of Vienna, Vienna, Austria. 2 Department of Radiation Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria Purpose/Objective: Whole-pelvis radiotherapy (WPRT) for locally advanced high-risk prostate cancer patients showed improved clinical outcomes compared to prostate-only radiotherapy (PORT) [1] with negligible impact on long- term adverse side effects [2]. However, real-world symptom data, especially for patients undergoing moderately-hypofractionated radiotherapy (MHRT), are scarce. This study reports prevalences of
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