S1190
Clinical - Urology
ESTRO 2026
Despite larger tumour sizes in medically inoperable patients, cancer control rates were high in both populations. Further comparative research is warranted to explore the role of SABR for medically operable patients. References: [1] Siva S, Bressel M, Sidhom M, Sridharan S, Vanneste BGL, Davey R, et al. Stereotactic ablative body radiotherapy for primary kidney cancer (TROG 15.03 FASTRACK II): a non-randomised phase 2 trial. Lancet Oncol 2024;25:308–16. https://doi.org/10.1016/S1470-2045(24)00020-2. Keywords: SABR, kidney, renal cell carcinoma Proffered Paper 1697 Salvage hypofractionated accelerated versus standard radiotherapy for biochemical recurrence after radical prostatectomy (SHARE): A phase 3 trial Youngju Song 1 , Won Park 2 , Hongryull Pyo 2 , Yeon Joo Kim 1 , Hanjong Ahn 3 , Young Seok Kim 1 1 Department of radiation oncology, Asan medical center, university of Ulsan college of medicine, Seoul, Korea, Republic of. 2 Department of radiation oncology, Samsung medical center, Sungkyunkwan university school of medicine, Seoul, Korea, Republic of. 3 Department of urology, Asan medical center, university of Ulsan college of medicine, Seoul, Korea, Republic of Purpose/Objective: To compare hypofractionated radiotherapy (RT) to conventional RT for biochemical recurrence after radical prostatectomy. Material/Methods: Between 2019 and 2021, 299 patients with intermediate- to high-risk prostate cancer and biochemical recurrence were randomized to receive salvage RT with either 65 Gy in 26 fractions (hypofractionated RT, HYPO) or 66 Gy in 33 fractions (conventional RT, CONV). Of these patients, 295 patients were included in the analysis. RT was delivered to the prostate bed, with elective pelvic nodal irradiation performed at the discretion of radiation oncologists. Intensity-modulated RT with daily image guidance was utilized. The primary endpoint was biochemical progression-free survival (bPFS). Secondary endpoints included distant metastasis-free survival (DMFS), prostate cancer- specific survival (CSS), toxicity profiles, and patient- reported quality-of-life. Results: Of the 295 patients, 151 (51.2%) received androgen deprivation therapy, and 202 (68.5%) underwent elective nodal irradiation. The median pre-RT prostate-
median of 29 months (IQR: 16-51). Mean age was 76.4±9.5 years for inoperable and 73.9±9.2 years for operable patients (p=0.07). Baseline eGFR was not significantly different between inoperable and operable patients (mean 56.5±19.6 vs. 57.9±17.3 mL/min/1.73m2, p=0.61). Operable patients underwent SABR due to technical risk (6%), risk of dialysis (55%), patient preference (20%), and other reasons (19%). Patients who were medically inoperable were more likely to have worse ECOG status, solitary kidney and comorbidities including myocardial infarction, congestive heart failure, peripheral vascular disease or cerebrovascular accidents (all p-values <0.01). Medically inoperable patients were also more likely to have a larger mean tumour size (4.9±1.5 cm vs. 4.1±1.6 cm; p<0.01). The RMST was 43 months (95% CI: 39-48) in inoperable patients and 52 months (95% CI: 48-56) in operable patients (p=0.007) (Figure 1). Furthermore, 2-year LC was 95% [95% CI: 86-99] in inoperable and 100% in operable patients (Figure 2), 2-year FFP was 90% [95% CI: 80-95] and 89% [95% CI: 79-94] respectively, while CSS was 100% in both arms. There were higher grade 3 events in inoperable compared to operable patients (7 vs. 3). There were no grade 4/5 adverse events.
Conclusion: Operable patients treated with renal SABR had higher survival compared to medically inoperable patients.
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