S1301
Clinical - Urology
ESTRO 2026
1 Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Tarragona, Spain. 2 Radiation Oncology Department, Hospital Viamed de Tarragona, Tarragona, Spain. 3 Pathology Department, Hospital Universitari Sant Joan de Reus, Tarragona, Spain. 4 Nuclear Medicine Department, Hospital Universitari Sant Joan de Reus, Tarragona, Spain. 5 Radiology Department, Hospital Universitari Sant Joan de Reus, Tarragona, Spain. 6 Urology Department, Hospital Universitari Sant Joan de Reus, Tarragona, Spain Purpose/Objective: To evaluate the added value of combining CT-PET (PSMA or Choline) with multiparametric MRI (PI-RADS) for clinical risk stratification in patients with unfavorable intermediate and high-risk localized prostate cancer, and to explore their association with tumor genomic alterations detected by next- generation sequencing (NGS). Material/Methods: This prospective study included 46 patients recently diagnosed with prostate cancer. Among them, 38 underwent MRI and 34 underwent CT-PET (PSMA or Choline). Risk classification was compared between conventional imaging (CT, bone scan, MRI) and CT-PET approaches. NGS was performed on biopsy specimens for all patients, and genomic alterations were categorized as actionable, non-actionable, or variants of uncertain significance (VUS). Changes in risk stratification were evaluated by calculating the rate of concordance between approaches. Fisher’s exact tests and multivariate logistic regression (age, PSA, ISUP, perineural invasion, cribriform pattern, PI-RADS) were used to examine associations between imaging findings and genomic alterations. Results:
After more than four years of follow-up, the RADIOSA trial confirms that adding short-term ADT to SBRT significantly improves CPFS and delays the onset of castration resistance in oligorecurrent hormone- sensitive PCa. However, the attenuation of the difference after testosterone recovery in terms of CPFS suggests that part of the benefit is driven by transient androgen suppression rather than by a sustained synergistic effect. These findings emphasize the dynamic nature of disease control after SBRT ± ADT and highlight the need for refined post-recovery endpoints to better capture long-term treatment impact beyond hormonal modulation. References: Marvaso G, Corrao G, Zaffaroni M, Vincini MG, Lorubbio C, Gandini S, Fodor C, Netti S, Zerini D, Luzzago S, Mistretta FA, Venetis K, Cursano G, Burla T, Mazzocco K, Cattani F, Petralia G, Fusco N, Pravettoni G, Musi G, De Cobelli O, Tang C, Ost P, Palma DA, Orecchia R, Jereczek-Fossa BA. ADT with SBRT versus SBRT alone for hormone-sensitive oligorecurrent prostate cancer (RADIOSA): a randomised, open-label, phase 2 clinical trial. Lancet Oncol. 2025 Mar;26(3):300- 311. doi: 10.1016/S1470-2045(24)00730-7. PMID: 40049196.CopyDownload .nbib Keywords: RADIOSA, SBRT, Prostate cancer, oligometastatic Imaging–Genomic Integration in Localized Prostate Cancer: MRI (PI-RADS), CT-PET (PSMA, Choline), and Genomic Alterations by NGS Ivan Henriquez 1 , Barbara Malave 2 , Raquel García- Pablo 1 , Gemma Benitez-Gabella 1 , Marta Canela 1 , Jorge Vargas 1 , Rocio Benavides 1 , David Parada 3 , Francesc Rius 3 , Jordi Fuertes 4 , Safae Abouzian 4 , Manuel Montero 5 , Ramon Bulto 6 , Vanessa Monllau 6 , Meritxell Arenas 1 Digital Poster 4606
Made with FlippingBook - Share PDF online