S1275
Clinical - Urology
ESTRO 2026
Mini-Oral 3788
toxicity, with 8% (4/51) Grade 2. At 12 months post- treatment, 25 patients reported GU toxicity, with 10% (5/51) Grade 2. One patient experienced Grade 3 urinary incontinence at 3-24 months post-treatment, on background of pre-treatment Grade 2 urinary incontinence. Of the 25 patients receiving SIB, 16 had recurrence at the postoperative vesicourethral anastomosis (67%). Higher toxicity rates were not observed in SIB vs non-SIB patients (Table 2). Excluding 20 patients on androgen deprivation therapy, PSA levels for remaining patients (31) exhibited a significant drop of 70% at 3 months.Short- term biochemical progression free survival remains excellent. 8 patients required further treatment for nodal or distant disease post-treatment in the setting of oligometastatic progression.Table 1. Recorded toxicities by CTCAE grading
Daily Adaptive MR-Guided RT Improves Urinary Symptoms in Prostate Cancer: A Prospective International Cohort Study (NCT04075305) Faye J Raaijmakers 1 , William A Hall 2 , Alison C Tree 3,4 , John C Christodouleas 5,6 , Sara Beltran Ponce 2 , Thomas Matoska 2 , Jochem van der Voort van Zyp 7 , Jasmijn M Westerhof 7 , Uulke A van der Heide 8 , Floris J Pos 8 , Casper Reijnen 9 , Ananya Choudhury 10,11 , Danny Vesprini 12 , Shaista Hafeez 13,4 , Elgin Hoffmann 14 , Michael W Straza 2 , Paul Jeene 15 , John M Longo 2 , Filippo Alongi 16,17 , Tine Schytte 18 , Matthieu Bal 19 , Juan Diaz 19 , Emma Hall 20 , Helena M Verkooijen 21 , Lois A Daamen 21 1 Computational Imaging Group for MR diagnostics & therapy, Center for Image Sciences, UMC Utrecht, Utrecht, Netherlands. 2 Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, USA. 3 Radiotherapy and Imaging Division, Institute of Cancer Research, London, United Kingdom. 4 Urology Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom. 5 Medical Affairs and Clinical Research, Elekta AB, Stockholm, Sweden. 6 Radiation Oncology, University of Pennsylvania, Philadelphia, USA. 7 Department of Radiation Oncology, UMC Utrecht, Utrecht, Netherlands. 8 Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, Netherlands. 9 Radiotherapy, Radboud Univserity Medical Center, Nijmegen, Netherlands. 10 Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom. 11 Department of Clinical Oncology, The Christie Hospitals NHS Foundation Trust, Manchester, United Kingdom. 12 Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. 13 Radiotherapy and Imaging Division, The Institute of Cancer Research, London, United Kingdom. 14 Department for Radiation Oncology and Radiotherapy, Universitätsklinikum Tübingen, Tübingen, Germany. 15 Radiotherapy, Radiotherapiegroep, Deventer, Netherlands. 16 Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella, Italy. 17 -, University of Brescia, Brescia, Italy. 18 Department of Oncology, Odense University Hospital, Odense, Denmark. 19 -, Elekta AB, Stockholm, Sweden. 20 Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom. 21 Division of Imaging and Oncology, UMC Utrecht, Utrecht, Netherlands Purpose/Objective: Assess whether daily online recontouring during magnetic resonance guided radiotherapy for prostate cancer affects urinary, bowel or sexual patient- reported quality of life (QoL), and to explore biological plausibility of these findings by analyzing changes in
Table 2. GU toxicities in SIB/non-SIB patients
Conclusion: Post-prostatectomy daily adapted MRgART, with or without SIB, appears safe without increased rates of early or late toxicities. Longer-term follow-up of patients in larger scale studies are needed to verify the safety and toxicity profiles of MRgRT PPRT and further explore survival rates. References: 1.Wegener, D., Thome, A., Paulsen et al., 2022. First experience and prospective evaluation on feasibility and acute toxicity of online adaptive radiotherapy of the prostate bed as salvage treatment in patients with biochemically recurrent prostate cancer on a 1.5 T MR- Linac. Journal of Clinical Medicine, 11(16), p.46512.Hassan, S.P., de Leon, J., Batumalai, V et al., 2024. Magnetic resonance guided adaptive post prostatectomy radiotherapy: Accumulated dose comparison of different workflows. Journal of Applied Clinical Medical Physics, 25(4), p.e14253 Keywords: MR-guided RT, post-prostatectomy, toxicity
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