S1244
Clinical - Urology
ESTRO 2026
Digital Poster Highlight 3000
immunotherapy.
Low rates of gynecomastia following neoadjuvant ADT combined with SBRT for localized prostate cancer Kelly Gaudian 1 , Maya Ferrell 1 , Min Jung Koh 2 , Anoud Abdul 3 , Sarthak Shah 4 , Malika Danner 5 , Alan Zwart 6 , Paul Leger 6 , Nancy Dawson 6 , Deepak Kumar 7 , Simeng Suy 5 , Sean P Collins 5 1 School of Medicine, Washington University, St. Louis, MO, USA. 2 School of Medicine, Georgetown University, Washington, DC, USA. 3 St. George's Hospital, St George's University, Newcastle Upon Tyne, United Kingdom. 4 Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. 5 Department of Radiation Oncology, University of South Florida Morsani College of Medicine, Tampa, FL, USA. 6 Department of Oncology, Georgetown University Medical Center, Washington, DC, USA. 7 Biotechnology Research Institute, North Carolina Central University, Durham, NC, USA Purpose/Objective: Androgen deprivation therapy (ADT) is commonly utilized in combination with stereotactic body radiotherapy (SBRT) for the treatment of localized prostate cancer. ADT agents, such as injectable gonadotropin-releasing hormone (GnRH) agonists or oral GnRH antagonists, are known to cause hormone- related side effects, including gynecomastia. The incidence and severity of bothersome breast tenderness or enlargement following short-course ADT and SBRT are poorly characterized. This study aimed to assess the gynecomastia burden in prostate cancer patients treated with GnRH agonists/antagonists alongside SBRT and its association with testosterone recovery. Material/Methods: Institutional IRB (IRB#: 2009-510) approval was obtained for retrospective review of prospectively collected data. Gynecomastia was measured using Question 13b of the Expanded Prostate Index Composite (EPIC-26) (EPIC Q13b), which assesses the presence/severity of breast enlargement and tenderness. Survey responses and serum testosterone were recorded at ADT initiation and every 3 months, with a median follow-up of 9 months. Follow-up timepoints with survey data varied between patients due to missed visits or incomplete survey completion. EPIC Q13b responses ranged from 0-4, and to capture clinically meaningful differences, were grouped as 0 (no symptoms), 1-2 (mild symptoms), and 3-4 (moderate to severe symptoms). Serum testosterone levels were measured at each follow-up. Results: From 2009 to 2024, 281 localized prostate cancer patients (12 low-, 180 intermediate-, and 89 high-risk)
Figure 1.
Figure 2. Conclusion:
SBRT demonstrated excellent local control in treated metastases and was independently associated with significantly improved PFS and OS in mRCC patients receiving immunotherapy. These findings suggest that SBRT is an effective and valuable adjunctive treatment for managing oligoprogressive disease in this setting, potentially prolonging systemic therapy benefit. Limitations include retrospective design and potential patient selection bias. Prospective studies are warranted to further validate these results. References: 1. Rühle A, Andratschke N, Siva S, Guckenberger M. Is there a role for stereotactic radiotherapy in the treatment of renal cell carcinoma?. Clin Transl Radiat Oncol. 2019;18:104-112. Published 2019 Apr 26.2.Hannan R, Christensen M, Hammers H, Christie A, Paulman B et al. Phase II Trial of Stereotactic Ablative Radiation for Oligoprogressive Metastatic Kidney Cancer. Eur Urol Oncol. 2022 Apr;5(2):216- 224.3. Sundahl N, Albiges L, Choueiri TK, De Bleser E, De Meerleer G, et al. Stereotactic Body Radiation Therapy Alone or in Combination with Immunotherapy in Kidney Cancer: A Systematic Review. Eur Urol. 2025 Aug;88(2):142-154. Keywords: RCC, SBRT, immunotherapy
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