S1302
Clinical - Urology
ESTRO 2026
PCa patients who underwent a PT-reRT course between November-2023 and March-2025 and with at least one filled EORTC QLQ-C30 questionnaire were included in the present analysis. All PT patients at our institution are asked to fill the questionnaire on the first and last day of PT and every three months during follow-up (FU), as part of the Proton Registry (NCT05860361).EORTC QLQ-C30 consist of 30 questions covering five functional domains (physical, role, emotional, cognitive, and social), nine symptom scales (fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties), and a global health status (GHS) scale. Results: A total of 28 PCa patients completed the questionnaire at baseline. Among them, 25, 17, and 14 patients completed it at the end of PT, and at 3 and 6 months of FU, respectively. Median age at reRT was 77 years (IQR 72–83), and the median KPS was 100 (IQR 90– 100). The majority (22, 79%) received 35 Gy/5 fractions. Figure 1 shows the scores across timepoints for functional scales and GHS. Higher scores indicate better QOL. Data show consistently high functional scores, suggesting good QOL, with median values >80% for all domains. Although a slight decline was observed in cognitive functioning, the overall functional status remained stable. GHS scores were also stable, with mean values of 75% at baseline, 67% at the end of PT, 83% at 3 months, and 75% at 6 months.Figure 2 illustrates the distribution of symptom scale scores, where higher values denote greater symptom burden. Fatigue scores remained stable across all timepoints, while insomnia and constipation showed an improving trend during follow-up. Other symptom scales were not displayed, as their median values were 0 at all evaluated timepoints, indicating negligible symptom presence.
Adding CT-PET to MRI-based assessment resulted in upstaging in 51.5% of patients, leading to modifications in therapeutic management. Genomic alterations were detected in 67.4% of patients, most of which were non-actionable variants. PI-RADS 5 lesions were more likely to harbor genomic alterations than PI-RADS 4 lesions (p = 0.049) (Figure 1). No significant association was found when clinical variables were included in the multivariate model, and PSMA uptake patterns did not correlate with genomic status. Conclusion: The combined use of MRI and CT-PET improves risk stratification in localized prostate cancer. The high prevalence of genomic alterations, particularly in PI- RADS 5 lesions, suggests a potential imaging–genomic relationship warranting further investigation. Integrating advanced imaging with tumor genomics may enhance personalized decision-making in prostate cancer management. References: 1. Emmett L, Buteau J, Papa N, Moon D, Thompson J, Roberts MJ, et al. The additive diagnostic value of prostate-specific membrane antigen positron emission tomography computed tomography to multiparametric magnetic resonance imaging triage in the diagnosis of prostate cancer (PRIMARY): a prospective multicentre study. Eur Urol. 2021;80(6):682-689. doi:10.1016/j.eururo.2021.08.002.2. Hatano K, Nonomura N. Genomic profiling of prostate cancer: an updated review. World J Mens Health. 2022;40(3):368- 379. doi:10.5534/wjmh.210072. Keywords: Prostate cancer, Imaging biomarkers, Radiogenomics RE-IRRADIATION WITH PROTON THERAPY: QUALITY OF LIFE IN PROSTATE CANCER PATIENTS TREATED AT EUROPEN INSTITUTE OF ONCOLOGY Maria Giulia Vincini, Giulia Marvaso, Chiara Lorubbio, Federico Mastroleo, Sabrina Clobiaco, Giovanni Carlo Mazzola, Dario Zerini, Costantino Putzu, Karl Amin, Daniela Alterio, Barbara Alicja Jereczek Radiation Oncology, IEO, IRCCS, Milan, Italy Purpose/Objective: Proton therapy (PT) enables precise dose delivery with optimal sparing of healthy tissues. Re-irradiation (reRT) with photons has shown benefits, but carries high toxicity risks which can jeopardize quality of life (QOL). The aim of the present study is to present results of a prospective data collection of QOL questionnaires in prostate cancer (PCa) patients who underwent reRT with PT at the IEO. Material/Methods: Digital Poster 4617
Conclusion: The findings of this study highlight the overall stability of QoL among patients undergoing PT-reRT, with high median scores across functional domains and global health status. The minimal symptom burden indicates that PT-reRT is a well-tolerated treatment option, offering a promising approach for preserving QoL in this patient population. Keywords: proton therapy; re-RT; PCa; quality of life;
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