S1263
Clinical - Urology
ESTRO 2026
Results: Between 2022 and 2025, 46 consecutive pts (63% UIR, 37% HR) were enrolled, while 41 completed the treatment as per protocol. Median age was 78 years (range 65–81). Median baseline PSA was 6 ng/mL (range 2.1–20), and median IPSS score was 6 (range 1– 14). No grade 3 or 4 side effects were observed. The incidence of grade ≥ 2 GU and GI side effects was 12.2% and 10% at 1 month, 7.7% and 2.6% at 3 months, and 2.6% and 2.6% at 6 months, respectively. A transient increase in the IPSS score was observed at 1 month, showing transient worse urinary symptoms as well as a near complete recovery within 6 months. Sexual function showed an early decline after SBRT, higher in the ADT + SBRT arm (81% vs 56%), with no significant recovery at 6 months. No relapses were observed at a median follow-up of 9 months. Conclusion: Our findings confirm that fiducials-free prostate SBRT is feasible and well tolerated. The incidence of GU and GI side effects was low and it was higher at 1 month with a progressive recovery within 6 months. The most common side effect was sexual disfunction, particularly in pts receiving ADT. Longer follow-up is needed to confirm tolerability and safety of this approach. Keywords: Prostate, fiducials-free SBRT, side effects Mini-Oral 3452 Efficacy and Toxicity of Hypofractionated and Dose-Boosted Radiotherapy for Localised Prostate Cancer: A Systematic Review and Meta-Analysis Marcin Miszczyk 1 , Nishan Sohoni 2 , Shayan Smani 2 , Matthias Moll 3 , Ahmed R Alfarhan 1 , Navid Roessler 1 , Keiichiro Miyajima 1 , Shota Inoue 1 , Giulia Marvaso 4 , Federico Mastroleo 4 , Constantinos Zamboglou 5 , Timo FW Soeterik 6 , Thomas Zilli 7 , Mario Terlizzi 8 , Pierre Blanchard 8 , Pawe ł Rajwa 1 , Tamás Fazekas 1 , Guillaume Ploussard 9 , Michael S Leapman 2 , Oliver Blanck 10 , Shahrokh F Shariat 1 , Barbara A Jereczek-Fossa 4 1 Department of Urology, Medical University of Vienna, Vienna, Austria. 2 Department of Urology, Yale School of Medicine, New Haven, USA. 3 Department of Radiotherapy, MedAustron Ion Therapy Centre, Wiener Neustadt, Austria. 4 Department of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy. 5 Department of Radiation Oncology, German Medical Institute, Limassol, Cyprus. 6 Department of Urology, St. Antonius Hospital, Nieuwegein/Utrecht, Netherlands. 7 Radiation Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland. 8 Department of Radiation Oncology, Gustave Roussy, Villejuif, France. 9 Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France. 10 Department
Keywords: real-world data, intermediate-risk prostate cancer
Digital Poster 3434
Fiducials-free stereotactic prostate radiotherapy: first report on safety in a subgroup of patients enrolled in a clinical trial Ercole Mazzeo 1 , Giulia Miranda 2 , Marco Vernaleone 1 , Elisa Cenacchi 3 , Francesca Incalcaterra 2 , Maria Victoria Gutierrez 3 , Dario Corbelli 2 , Cecilia Cadioli 3 , Enrico Turco 1 , Giulia Stocchi 1 , Daniele Bosi 1 , Giorgia Pisa 1 , Gabriele Guidi 3 , Alessio Bruni 1,2 1 Radiotherapy Unit, Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy. 2 Radiotherapy Unit, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, Modena, Italy. 3 Medical Physics Unit, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy Purpose/Objective: Stereotactic body radiotherapy (SBRT) emerged as an effective treatment for prostate cancer. The role of SBRT alone or in combination with androgen deprivation therapy (ADT) in patients (pts) with unfavorable intermediate (UIR) or high-risk (HR) disease remains uncertain. We report preliminary results on acute side effects using a fiducials-free ultra-hypofractionated treatment in a subgroup of pts enrolled in a multicentric randomized phase III trial. Material/Methods: All pts had UIR/HR prostate cancer and were staged with CT and bone scan, while PSMA-PET was allowed in selected cases. Pts were randomized 1:1 to receive either SBRT alone (36.25Gy/5#) or SBRT combined with ADT (single 6-month depot of triptorelin). Treatment was delivered with daily image guidance using cone- beam CT (CBCT) and real-time monitoring with Clarity® transperineal ultrasound system. Acute genitourinary (GU) and gastrointestinal (GI) side effects ( ≤ 6 months) were graded according to CTCAE v5.0, while quality of life was assessed with validated questionnaires: EPIC-26, EORTC QLQ-PR25, IPSS, and IIEF.
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