S1210
Clinical - Urology
ESTRO 2026
lesion boosts (40–42/42.5 Gy in 5 fractions) were delivered selectively at the treating physician’s discretion based on anatomical considerations and disease characteristics. Rectal spacer and endorectal balloon were uniformly applied. EPIC-26 questionnaires were administered at baseline and 1, 3, 6, 9, and 12 months. Changes from baseline ( Δ ) were analysed across urinary incontinence (UI), urinary irritative/obstructive, bowel, sexual, and hormonal domains. Clinically meaningful change was defined using validated thresholds (UI > 6; irritative/obstructive > 5; bowel > 4; sexual > 12). Rank-sum and Chi-square tests compared baseline characteristics between cohorts for imbalance. Results: Baseline clinical parameters were comparable between cohorts (all p < 0.05). Across urinary irritative/obstructive, bowel, and hormonal domains, both SBPT and MRgSBRT maintained mean Δ scores below thresholds for clinically meaningful decline, indicating preserved functional status over the first treatment year. Sexual QoL declined similarly in both groups (mean Δ >12), a pattern that may reflect the combined treatment-related effects seen in high-risk prostate cancer, including the potential influence of androgen deprivation therapy. A clear divergence emerged in urinary continence. SBPT maintained stable continence across all timepoints (mean Δ ≤ 6), whereas MRgSBRT demonstrated a progressive decline beginning at 3 months and persisting through 12 months (mean Δ >6). All other QoL domains exhibited parallel trajectories between the two techniques.Table 1: Patient characteristics
Figure 1: Quality of life assessment in the urinary, bowel, hormonal, and sexual domains using EPIC-26
Conclusion: To our knowledge, this represents the first prospective, head-to-head clinical comparison of 5- fraction SBPT and 5-fraction MR-guided SBRT, demonstrating a late urinary-continence signal favouring SBPT while showing comparable outcomes across other QoL domains. These findings warrant validation in larger multi-institutional studies and may help inform future treatment selection for patients in whom urinary continence preservation is a priority. References: 1.Chen RC et al. JAMA Oncol. 2020;6:735–743.2.Kishan AU et al. Lancet Oncol. 2022;23:1048–1059.3.Alongi F et al. Radiother Oncol. 2020;152:88–96.4.Skolarus TA et ak, Urology. 2015; 85(1):101-5. Keywords: prostate cancer, quality of life, radiotherapy
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