S1281
Clinical - Urology
ESTRO 2026
University (UPF), Barcelona, Spain. 3 Nuclear Medicine, Hospital Del Mar, Barcelona, Spain. 4 Laboratory Medicine, Hospital Josep Trueta, Girona, Spain. 5 Radiation Oncology, Hospital Del Mar, Barcelona, Spain Purpose/Objective: In biochemical-recurrence(BCR) of prostate-cancer(PC) after radical-prostatectomy(RP), conventional imaging shows limited-sensitivity for early-disease-detection. PSMA-PET/CT enables accurate localization even at low PSA-levels. Among available-tracers, ¹⁸ F-DCFPyL-PSMA and ¹⁸ F-PSMA-1007 are most-used. This study aimed to compare both tracers in terms of disease-detection- rate(DR) and their influence on therapeutic- management, assessing changes from the original to the post-PSMA treatment-intent Material/Methods: A prospective study was conducted including 171 patients with BCR after RP as primary curative- treatment. Eligibility-criteria included PSA-levels between0.2-1.0ng/mL, with/without prior adjuvant/salvage radiotherapy(RT), and negative- conventional-imaging (CT, bone-scan, pelvic-MRI). A total of 158 patients met inclusion-criteria and underwent PSMA-PET/CT, 73 with ¹⁸ F-DCFPyL-PSMA and 85 with ¹⁸ F-PSMA-1007. Scans were evaluated following PROMISE-V2-criteria. The primary-endpoint was the change in therapeutic-management between the original and post-PSMA treatment-intent, categorized as: (0)no-change; (1)moderate-change (addition of elective-pelvic-nodal-RT or dose-escalation to PSMA-positive pelvic-nodes or prostate-bed ±ADT) and (2)major-change, where new M1-findings altered the original-treatment-strategy (systemic-therapy or different-RT-volumes). Secondary-endpoints included DR by clinical/biochemical-variables(Gleason-score, ISUP-group, PSA<0.5, 0.5–1.0ng/mL, DT-PSA<6, 6–12, >12months), and ROC-derived cut-off PSA-values. Results: Among 158 analyzed patients, baseline-characteristics were similar between-groups(table-1).
Conclusion: Minimum anal canal dose and a history of haemorrhoids appear to be associated with faecal incontinence two years after moderately hypofractionated VMAT/IGRT for localised prostate cancer. These findings suggest that minimising radiation exposure to the anal canal may help reduce late faecal incontinence. In addition, a prior history of haemorrhoids should be considered when discussing the indication for radiotherapy with the patient. Further prospective validation in larger cohorts is warranted. References: The study was registered on clinicaltrials.gov (NCT04262609) on 5 February 2020 Keywords: Faecal incontinence, VMAT, prostate cancer Digital Poster Highlight 3947 Comparative Analysis of ¹⁸F-DCFPyL-PSMA vs ¹⁸F- PSMA-1007 PET/CT: Impact on Therapeutic Management and Change in Treatment Intent After PSMA Imaging Francesco Amorelli 1,2 , Pedro Jose Plaza 3 , Augusto Octavio Natali 4 , Palmira Foro 5 1 Radiation Oncology, Catalan Institute of Oncology (ICO), Barcelona, Spain. 2 PhD Program, Pompeu Fabra
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