S1194
Clinical - Urology
ESTRO 2026
CTCAE G2+ events at 2 years are: P 14/234 (6%), P-B 29/298 (10%), PPN-B 26/302 (9%). Conclusion: With moderate hypofractionation, adding a boost in the absence of pelvic node radiotherapy does not increase early GI side effects; early G2+ GU side effects were transiently increased. With prostate plus pelvic node radiotherapy, adding a boost has minimal impact on early toxicity. References: 1. Syndikus I, Cruickshank C, Staffurth J, Tree A, Henry A, Naismith O, Mayles H, Snelson N, Hassan S, Brown S, Porta N, Griffin C, Hall E, on behalf of the PIVOTALboost Trial Management Group (2020). PIVOTALboost: A phase III randomised controlled trial of prostate and pelvis versus prostate alone radiotherapy with or without prostate boost (CRUK/16/018). Clinical & Translational Oncology. 25:22-8. Keywords: Prostate, Focal boost, RCT Correlation Between PSMA PET/CT and Artera-AI Prostate Test in Intermediate Risk Prostate Cancer Patients Olivia Jo 1 , Nadia Falzone 1 , Matthew Wong 1 , Angela Benson 1 , Becky Nathan 1 , Michael Chao 1 , Mario Guerrieri 1 , Eric Wegener 1 , Jarad Martin 1 , Tim Showalter 2 , Michael Ng 1 1 Radiation Oncology, GensisCare, Melbourne, Australia. 2 Radiation Oncology, ArteraAI, Melbourne, Australia Purpose/Objective: Short-term androgen deprivation therapy (ST-ADT) have been shown to improve efficacy of definitive radiation therapy in intermediate risk prostate cancer (IRPC) [1]. Artera-AI Prostate-Test is an artificial intelligence based clinico-pathological biomarker that gives prognostic information of distant metastasis risk and predictive information on ST-ADT benefit [2]. PSMA-PET/CT has shown improved staging of prostate cancer with emerging prognostic utility [3]. We aim to assess whether there is a correlation between staging-PSMA PET/CT and Artera-AI Prostate- Test in IRPC patients being considered for radiotherapy. Material/Methods: Mini-Oral 1793 Data were collected retrospectively under GCOP- approved protocol 2022/ETH00247, with patients identified from the ASTUTE trial (ACTRN12623000713695), a multicentre study aiming to recruit 800 participants to evaluate changes in shared decision-making regarding ADT in individuals considered for radiation therapy [4]. Eligible patients
biochemical/clinical failure. Proportion of patients receiving P-B and PPN-B with any grade 2 or higher (G2+) gastrointestinal (GI) and genitourinary (GU) side effect up to 18 weeks were compared with patients receiving P using chi-squared test.
Results: Of 2232 men recruited, 1465 were randomised in the boost comparisons (P: 388; PPN: 151; P-B: 464; PPN-B: 462; with focal-IMRT boosting for 88% (815/926)). 88% had high risk disease. Median PSA at entry 10.9ng/ml.Table 2 shows GI and GU CTCAE worst side effects to 18 weeks. G3+ side effects were rare.
Early GI CTCAE G2+ side effects with P-B were similar to P but nearly three-fold with PPN-B (P 10.9%; PPN 30.6%; P-B 14.8%; PPN-B 29.3%; P vs P-B p=0.096; P vs PPN-B p<0.0001). Most frequent early GI effects were diarrhoea, proctitis. Side effects had largely resolved by 18 weeks. Two-year data on 834 (63%) patients suggest low G2+ rates: P 8/234 (3%), P-B 9/298 (3%), PPN-B 4/302 (1%). Similar patterns seen for RTOG G2+.Cumulative early GU CTCAE G2+ side effects were higher with P-B and PPN-B: P 40.2%; PPN: 49.7%; P-B 48.7% (p=0.014); PPN-B 49.2% (p=0.010) but prevalence was similar at 18 weeks. Early GU RTOG G2+ events were slightly raised in P-B and PPN-B. GU
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