S1269
Clinical - Urology
ESTRO 2026
Conclusion: Concurrent CRT achievedhighrates of bladderpreserva tion and survivalwith a lowincidence of ≥ grade 3 toxicity, bothacute and late. Outcomes, comparable to multicenter trials such as BC2001, RTOG 0712, and BCON, support CRT as aneffective and safealternative to radical cystectomy in selectedpatientswithlocalized MI BC. References: James ND, Hussain SA, Hall E, Jenkins P, Tremlett J, Rawlings C, et al. Radioterapia con o sin quimioterapia en el cáncer de vejiga músculo- invasivo . N Engl J Med . 2012 ;366 (16):1477- 88.Mak RH, Hunt D, Shipley WU, Efstathiou JA, Test er WJ, Hagan MP, et al. Resultados a largo plazo en pacientes tratados con quimiorradiación por enfermedad músculo-invasiva.Cáncer de vejiga : resultados del RTOG 0712. J Clin Oncol . 2014 ;32 (34):3801-09.Choudhury A, Porta N, Hall E, Jenkins P, Elliott T, Sangar V, et al. Modificación de la hipoxia combinada con radioterapia radical para el cáncer de vejiga músculo-invasivo : resultados a largo plazo del ensayo BCON. Lancet Oncol . 2021 ;22 (4):490-500. Keywords: Bladder preservation Digital Poster 3510 Next-Generation sequences in metastatic prostate cancer: a mono-institutional real-world experience. Calogero Casà 1 , Giorgio Caramia 1 , Beatrice Di Capua 2 , Antonella Mecozzi 3 , Marco Pierleoni 4 , Domenico Fusco 5 , Emilio Sacco 6 , Emilio Bria 3 , Vincenzo Valentini 2 , Luca Tagliaferri 7 , Francesco Miccichè 1 1 UOC di Radioterapia, Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy. 2 Centro D'Eccellenza Oncologia Radioterapica e Medica e Diagnostica per Immagini, Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy. 3 UOC di Oncologia Medica, Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy. 4 UOC di Diagnostica per Immagini, Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy. 5 UOC Pronto Soccorso, Medicina d’Urgenza e Medicina Interna, Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy. 6 UOC di Urologia, Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy. 7 UOC Degenza di Radioterapia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Digital Poster 3532
Pre-radiotherapy PSA as an independent predictor of biochemical recurrence in high-risk prostate cancer: A single-institution study. Fatjona Kraja 1,2 , Aurel Janko 1,3 , Rezart Xhani 1,4 , Edit Zaganjori 2 , Florina Hoxha 2 , Gezim Galiqi 5 1 Surgery, Faculty of Medicine, University of Medicine, Tirana, Albania. 2 Oncology, UHC Mother Teresa, Tirana, Albania. 3 Urology, UHC Mother Teresa, Tirana, Albania. 4 Urology, Faculty of Medicine, University of Medicine, Tirana, Albania. 5 Urology, Shkodra Regional Hospital, Shkoder, Albania
Purpose/Objective: To investigate prognostic factors influencing
biochemical recurrence (BCR) in patients with high-risk prostate cancer treated with definitive moderate hypo- fractionated radiotherapy (RT), with a specific focus on the prognostic value of pre-radiotherapy PSA levels. Material/Methods: A retrospective analysis was conducted on 100 patients with high-risk prostate cancer treated between 2018 and 2023. All patients received 1–3 months of neoadjuvant androgen deprivation therapy (ADT) prior to radiotherapy (RT) and continued ADT for up to 36 months. Radiotherapy was delivered using volumetric modulated arc therapy (VMAT) with a simultaneous integrated boost (SIB) to the prostate, seminal vesicles and pelvis, to a total dose of 70.2 Gy in 26 fractions. Biochemical recurrence (BCR) was defined according to the Phoenix criteria (nadir + 2 ng/mL). Univariate and multivariate analyses were performed to evaluate the correlation between BCR and clinical parameters, including Gleason score (GS), initial PSA, pre-RT PSA, and T stage. Results: The mean patient age was 75.4 years (range 52–96). Tumor characteristics included GS ≤ 7 in 21%, GS 8 in 28%, and GS 9–10 in 51%; 50% were cT3b and 21% cN+. Mean initial PSA was 32 ng/mL (14–100) and mean pre-RT PSA was 1.0 ng/mL (0.1–2.5). Half of the patients had a pre-RT PSA ≤ 0.5 ng/mL. On univariate analysis, Gleason >8, initial PSA >20 ng/mL, and higher pre-RT PSA were associated with recurrence (p<0.05). Pre-RT PSA remained an independent predictor in multivariate analysis (HR 2.1; 95% CI 1.3–3.4; p=0.02). Among these, patients with pre-RT PSA > 1.0 ng/mL had approximately 1.5 times higher risk compared with the >0.5 ng/mL group, corresponding to an overall 4.5-fold higher risk compared with patients achieving pre-RT PSA ≤ 0.5 ng/mL (HR 4.5; 95% CI 1.95– 11.7; p < 0.001). At a median follow-up of 54 months (24–82), 13 patients experienced BCR, all of whom had pre-RT PSA levels > 0.5 ng/mL. The 3- and 5-year BCR- free survival were 95.8% and 90.3%. Conclusion:
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