S1272
Clinical - Urology
ESTRO 2026
7 Radiation Oncology, Dana-Farber Cancer Institute, Boston, USA
Digital Poster 3658
Real-world oncological outcomes of metastasis- directed therapy for synchronous oligometastatic prostate cancer: propensity score-matched analysis Magdalena Stankiewicz 1 , Mateusz Bilski 2,3 , Igor Banaszek 4 , Katarzyna Kuncewicz 4 , Ł ukasz Kuncman 5,6 , Krzysztof Bu ł acz 6 , Giulio Francolini 7 , Pietro Garlatti 7 , Michele Aquilano 7 , Dorota E. Kazberuk 8 , Anna Szmigiel- Trzci ń ska 8 , Andrzej Kukie ł ka 9,10 , Katarzyna Konat- B ą ska 11 , Alekdandra Krzywo ń 12 , Marta Szlag 13 , Piotr Wojcieszek 1 , Wojciech Majewski 14 1 Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland. 2 Department of Brachytherapy, Saint John’s Cancer Center, Lublin, Poland. 3 Department of Radiotherapy, Medical University of Lublin, Lublin, Poland. 4 Department of Radiotherapy, Saint John’s Cancer Center, Lublin, Poland. 5 Department of Radiotherapy, Medical University of Lodz, Lodz, Poland. 6 Department of External Beam Radiotherapy, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland. 7 Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy. 8 Radiation Oncology and Brachytherapy Department, Maria Sklodowska-Curie Oncology Center in Bialystok, Bialystok, Poland. 9 -, NU-MED Cancer Diagnostics and Therapy Centre, Zamosc, Poland. 10 Department of Brachytherapy, University Hospital in Krakow, Krakow, Poland. 11 Radiotherapy Department, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland. 12 Department of Biostatistics and Bioinformatics, Maria Sklodowska- Curie National Research Institute of Oncology, Gliwice, Poland. 13 Radiotherapy Planning Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland. 14 Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland Purpose/Objective: Data regarding the role of combined prostate and metastasis-directed radiotherapy (RT) in synchronous oligometastatic prostate cancer (omPC) remain limited. While metastasis-directed therapy (MDT) benefits have been shown in metachronous disease, its impact in synchronous setting remains unclear. This multicentre retrospective study compared comprehensive local therapy (RT to prostate ± nodes + all metastases) with systemic therapy and incomplete or no local treatment, focusing on propensity score- matched analysis to explore the observed trend toward inferior overall survival (OS). Material/Methods: We analysed 217 patients with synchronous omPC
Purpose/Objective: To evaluate whether a hyaluronic acid (HA) rectal spacer prior to hypofractionated prostate radiation therapy can reduce late grade 2 or higher gastrointestinal (GI) adverse events at 36-months. Material/Methods: From March 30, 2020, through June 29, 2021, 201 patients with low or intermediate risk prostate cancer were randomized (2:1) to the presence or absence of a HA spacer, prior to hypofractionated prostate radiation therapy (RT) (60 Gy in 20 fractions)[1]. An independent core laboratory prospectively reviewed treatment plans. Cumulative incidences of late (6 to 36 months from baseline) grade 2 or higher GI and genitourinary (GU) adverse events (CTCAE v5.0), which were at least "possibly related" to radiation therapy, were calculated using Kaplan-Meier analysis. Comparisons across treatment arms were made with log-rank tests. alpha = 0.05 was the a-priori level of significance. Results: The median follow-up was 36 months. None (0%) of 134 patients in the spacer arm experienced a grade 2 or higher late GI adverse event, compared to 6 (9.5%) of 63 patients (2 proctitis; 1 diarrhea; 1 hemorrhoidal hemorrhage; 1 bright red blood per rectum; 1 rectal bleeding) in the control arm. The spacer arm exhibited a significantly reduced cumulative incidence of late grade 2 or higher GI adverse events than the control arm (log-rank p = 0.0002) . Respective 36-month cumulative incidence estimates were 0% versus 8.0%. The spacer arm had a numerically lower proportion of late grade 2 or higher GU adverse events (7/134, 5.2%) compared to the control arm (6/63; 9.5%), but the difference was not significant (log-rank p = 0.29). Respective 36-month cumulative incidence estimates were 5.4% versus 9.7%. Conclusion: In this modern multi-institutional trial with prospective plan review, the HA rectal spacer was associated with reduced late grade 2 or higher GI adverse events after hypofractionated RT. References: [1] Mariados NF, Orio PF, Schiffman Z, Van TJ, Engelman A, Nurani R, Kurtzman SM, Lopez E, Chao M, Boike TP, Martinez AA, Gejerman G, Lederer J, Sylvester JE, Bell G, Rivera D, Shore N, Miller K, Sinayuk B, Steinberg ML, Low DA, Kishan, AU, King MT. Hyaluronic acid spacer for hypofractionated prostate radiation therapy. JAMA Oncol. 2023; 9(4): 511-518. PMID: 36757690. Keywords: Prostate, spacing, randomized
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