S1304
Clinical - Urology
ESTRO 2026
one improved, two worsened (G2), and one remained stable(graphic1). One new-onset G2 urgency incontinence occurred. In acute, GI toxicities appeared in 50% pf pts at a median of 12 days: diarrhoea (G2 in41.6%), proctitis (G1 in16.6%,G2 in 1 pt for haematochezia); 33.3% received corticosteroid suppositories.During follow-up, GI toxicity resolved in all patients except for the one who experienced hematochezia, in whom proctitis persisted atG2. Questionnaire response rate was100%, and overall well-being was preserved. Sexual function was not evaluated due to ADT. No increase in toxicity was observed in patients who received the sequential nodal boost
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Feasibility of lymph node metastasis sequential boost following postprostatectomy SBRT with concomitant prophylactic pelvic nodes Margherita Rotondi 1 , Claudio Scoglio 1 , Enrico Raggi 1 , Francesca Ciriello 1 , Anna Schiattarella 1 , Olga Ionova 1 , Arta Sulaj 2 , Fabrizio Cupardo 2 , Stefano Ren Kaiser 2 , Rossella Vidimari 2 , Mara Severgnini 2 , Alessandro Magli 1 1 SC Radioterapia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy. 2 SC Fisica Sanitaria, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy Purpose/Objective: To evaluate genitourinary (GU) and gastrointestinal (GI) toxicities and quality of life following stereotactic body radiotherapy (SBRT) to the prostate bed, concomitant prophylactic pelvic nodal irradiation (25Gy/5 fractions) and to assess the feasibility of sequential nodal boost (16Gy/2fr) in prostate cancer patients (pts) with recurrence/adverse pathologic features after radical prostatectomy Material/Methods: From March to September 2025, twelve patients(pts) post–radical prostatectomy were treated every-other- day. PSMA-PET was performed in patients with measurable PSA levels. Patients received SBRT to the prostate bed(31Gy-32.5Gy/5fr) ± simultaneous integrated boost(SIB: 35Gy-40Gy/5fr) + pelvic prophylactic nodal irradiation ± nodal sequential boost, using VMAT and guided by cone-beam CT(CBCT), including an additional intrafraction CBCT for motion correction. Toxicities were assessed according to CTCAEv6. Patient-reported quality of life was measured using the Functional Assessment of Cancer Therapy–Prostate(FACT-P) Results: Median follow-up was 5months. Median age was 68years. Setting was adjuvant and salvage radiotherapy for six and six pts respectively, median time from radical prostatectomy was 15 months. Eleven pts received androgen deprivation therapy(ADT). Four patients were cN1(7 pathological nodes) treated with a sequential boost. Three patients received SIB to the prostate bed, one also treated nodal disease. A deescalation dose was prescribed for a pararectal N1(14Gy/2fr). Median OARs isodose are showed in the table1. Acute G1 urinary toxicity occurred in 41.66% of pts at a median of 7 days (dysuria, frequency and nocturia in 1,1,3 pts). All toxicities resolved during follow-up, except for persistent G1 nocturia in two pts. One further case of de novo G1 nocturia was recorded. Urinary incontinence was present at baseline in 41.66% of pts (16.6%G1, 25%G2) and during follow-up, one resolved,
Conclusion: Despite low numbers, sequential nodal boost during pelvic prophylactic irradiation in SBRT to the prostate bed appears feasible with manageable toxicity. Larger studies with longer follow-up are required to confirm these preliminary results Keywords: SBRT, prostate-bed, boost
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