S1295
Clinical - Urology
ESTRO 2026
survival rates were 97.1% (95% CI, 88.9–99.3) and 100%, respectively. Eighty-four patients were eligible for GU toxicity analysis. Acute and late GU toxicities of grade ≥ 2 occurred in 41.7% and 30.9% of patients, respectively, with no GU grade ≥ 3 or gastrointestinal (GI) grade ≥ 2 events observed. Median urethral D0.1 cc and bladder D2 cc were 53.6 and 55.4 GyE, respectively. No significant correlations were found between dose parameters and GU toxicity. Baseline GU grade showed a modest association with bladder dose (p = 0.007), whereas prostate volume had no significant effect.
2017;47(6):1055-1073. doi:10.1007/s40279-016-0648- 0Hamblen AJ, Bray JW, Hingorani M, Saxton JM. Physical activity and dietary considerations for prostate cancer patients: future research directions. Proc Nutr Soc. 2023;82(3):298-304. doi:10.1017/S0029665123000046 Keywords: Physical Activity, Mediterranean Diet, Metabolic
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Early Clinical Outcomes and Dose–Toxicity Profile of Dose-Escalated Carbon-Ion Radiotherapy for Localized Prostate Cancer CHI-CHUAN CHIOU, Keng-Li Lan, Yu-Wen Hu, Yuan- Hung Wu, Tzu-Yu Lai, Yu-Mei Kang, Yu-Ming Liu Department of Heavy Particles and Radiation Oncology, Taipei Veterans General Hospital, Taipei, Taiwan Purpose/Objective: Carbon-ion radiotherapy (CIRT) offers superior dose conformity and increased biological effectiveness compared with conventional photon radiotherapy in the management of localized prostate cancer. However, the safety and efficacy of dose-escalated regimens beyond the established Japanese prostate CIRT protocols remain to be fully elucidated, particularly regarding urethral and bladder dose constraints. This study evaluated early clinical outcomes and dose–toxicity relationships of a single- institution, dose-escalated CIRT protocol. Material/Methods: We retrospectively reviewed patients with node- negative, localized prostate cancer treated with CIRT between June 2022 and October 2025. Three patients received the standard 51.6 Gy(RBE)/12-fraction protocol, while subsequent patients underwent a dose-escalated regimen delivering up to 59.4–60 Gy(RBE)/12 fractions to MR–DWI–avid lesions, 54 Gy(RBE)/12 fractions to the prostate excluding the urethra, and 51.6 Gy(RBE)/12 fractions to the entire gland. Dose escalation was permitted only when rectal and bladder constraints were satisfied. Treatment planning was performed using the Japanese microdosimetric kinetic model with single-field-per- day delivery. Genitourinary (GU) toxicities were graded per CTCAE v4.0, with late toxicity defined as grade ≥ 2 events occurring > 90 days post-CIRT. Associations between urethral D0.01 cc, bladder D2 cc, and GU toxicity were examined using the Mann–Whitney U test and logistic regression analysis. Results: Among 136 treated patients (excluding two without follow-up), the median follow-up was 12.1 months. The 1-year biochemical relapse-free and overall
Conclusion: Dose-escalated carbon-ion radiotherapy demonstrated excellent early biochemical control and a favorable toxicity profile, with no severe genitourinary or gastrointestinal adverse events. These findings indicate that moderate dose escalation beyond the Japanese prostate CIRT standard is both feasible and well tolerated, although longer follow-up is warranted to confirm long-term safety and efficacy. References: 1. Nomiya T, Tsuji H, Maruyama K, Toyama S, Suzuki H, Akakura K, Shimazaki J, Nemoto K, Kamada T, Tsujii H; Working Group for Genitourinary Tumors.Phase I/II
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