S1183
Clinical - Urology
ESTRO 2026
Conclusion: In patients with non-metastatic MIBC treatment with either RC or BPT results in equivalent oncological outcomes at 5 years. Keywords: MIBC, radical cystectomy, bladder preservation
NAC, with 92% (n=97/106) receiving cisplatin combination regime (85% cisplatin/ gemcitabine, 5% MVAC, 2% other). The predominant radical radiotherapy schedule was 55Gy/20# in 87% (n=244), and palliative radiotherapy schedule 30-36Gy/6# in 37% (n=98). CRS was administered in 59% patients (n=180/304) with weekly gemcitabine the most common regime used in 52% (n=93/180). The radiotherapy target was bladder alone in 88% (n=269/304). There was a higher uptake of CRS in patients who did not have NAC (33%, n=99/304) as compared to those who did have NAC (26%, n=80/304). Conclusion: This re-evaluation is the largest multicentre prospective study, at a population level internationally to define contemporary management of MIBC in patients receiving radiotherapy within the UK. Timelines to commencing definitive treatment confirm a continued urgent need to streamline the pathway. Within this elderly population the use of NAC has reduced as compared to the initial evaluation, but there has been a marked improvement in the use of evidence-based CRS. Though an increase in the penetrance of CRS is demonstrated, there remains a need to improve time to treatment as well as understanding the impact of comorbidity on treatment allocation. References: 1.Coleman, M. P. et al., (2025). Trends over 48 years in a one-number index of survival for all cancers combined, England and Wales (1971–2018): a population-based registry study. The Lancet Regional Health–Europe, Volume 56, 101385.2. Royal College of Radiologists. (2023, May). Bladder Cancer: RCR Consensus Statements. Retrieved from Royal College of Radiologists: https://www.rcr.ac.uk/our-services/all- our-publications/clinical-oncology- publications/bladder-cancer-rcr-consensus- statements/3. Varughese, M. et al., (2019). Radiotherapy Management of Muscle Invasive Bladder Cancer: Evaluation of a National Cohort. Clinical Oncology, Volume 31, Issue 9, 637 - 645. Keywords: bladder cancer, review of UK radiotherapy practice
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Radiotherapy Management of Muscle Invasive Bladder Cancer: Re-evaluation of UK Practice against The Royal College of Radiologists Consensus Statements Mohini Varughese 1,2 , Sarah Treece 3 , Karl Drinkwater 4 1 Department of Oncology, Royal Devon University Hospital NHS Foundation Trust, Exeter, United Kingdom. 2 Medical Sciences, University of Exeter, Exeter, United Kingdom. 3 Department ofOncology, Peterborough City Hospital North West Anglia NHS Foundation Trust, Norwich, United Kingdom. 4 Audit and Quality Improvement Partner, The Royal College of Radiologists, London, United Kingdom Purpose/Objective: With evidence of worsening outcomes for patients diagnosed with bladder cancer1, there is an urgent need to understand the penetrance of evidence-based practice for patients undergoing bladder radiotherapy. The initial study benchmarked UK practice; neo adjuvant chemotherapy (NAC) was administered in 43%, concurrent radiosensitation (CRS) administered in 40% of patients2. Consequently, The Royal College of Radiologists (RCR) published the muscle invasive bladder cancer (MIBC) consensus statements3. This prospective study re-evaluates national practice. Material/Methods: UK radiotherapy centres were invited to complete a questionnaire for patients commencing bladder radiotherapy over a 16-week period from January 2025. Data covered patient, treatment and timing; analyses assessed practice and RCR compliance. Results: Eighty four percent (51/61) of UK radiotherapy centres submitted data for 568 patients. Median age was 79, with staging T2-4N0M0 in 73% (n=414), N+M0 in 11% (n=63), M+ in 13% (n=75). Performance status was WHO PS 0-2 in 491 patients (86%). Treatment intent was radical in 304 (54%) and palliative in 263 (46%). Timelines from transurethral resection of the bladder tumour to start of radiotherapy, if NAC not received, was median 75 days (IQR 58-105), 168 days (IQR 140-208) if NAC received. Time to NAC was 60 days (IQR 44-76), with time from radiotherapy referral to commencing radiotherapy 26 days (IQR 20- 31). Thirty five percent (n=106/304) of patients had
Proffered Paper 1415
PERSIAN TRIAL (NCT03449719): a randomized phase II trial testing Apalutamide and SBRT for hormone- sensitive prostate cancer Giulio Francolini 1 , Saverio Caini 2 , Vanessa Di Cataldo 1 , Pietro Garlatti 1 , Alessio Bruni 3 , Nicola Simoni 4 , Cinzia Iotti 5 , Roberto Iacovelli 6 , Luca Tagliaferri 7 , Chiara Ciccarese 8 , Nicola Battelli 9 , Gianluca Ingrosso 10 , Angelo Porreca 11 , Antonio Amodeo 11 , Gianluca Vullo 12 ,
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