S163
Brachytherapy - Urology
ESTRO 2026
HOPE and ARGOS patients, respectively. 95% and 100% received androgen deprivation therapy, respectively, for a median of 12 months (interquartile range: 6-18). No significant differences in baseline EPIC-26 scores were observed. At 1 and 2 years, no significant differences were observed between cohorts for bowel (Figure 1), urinary irritative/obstructive (Figure 2) or urinary incontinence EPIC-26 domains. However, change in urinary incontinence mean ± SD scores from baseline to 1 year favored ARGOS ( -10.4 ± 17.9 vs. − 1.4 ± 16.5, p=0.029). No significant differences emerged at later time points or in any other EPIC-26 domains. Both treatments were well tolerated, with only one grade > 3 late GI/GU toxicity, reported in the ARGOS cohort.
Proffered Paper 1459 Quality of Life Outcomes in Prostate HDR- Brachytherapy plus UH-WPRT vs. SBRT plus UH- WPRT: An Inter-Trial Comparison of HOPE and ARGOS Lucas C Mendez 1 , Andrew Warner 1 , David D'Souza 1 , Juanita Crook 2 , Kevin Martell 3 , Bryan Schaly 4 , Hatim Fakir 4 , Doug Hoover 4 , Andrew Loblaw 5 , Glenn Bauman 1 1 Radiation Oncology, London Health Sciences Centre, London, Canada. 2 Radiation Oncology, BC Cancer, Kelowna, Canada. 3 Radiation Oncology, Tom Baker Cancer Centre, Calgary, Canada. 4 Medical Physics, London Health Sciences Centre, London, Canada. 5 Radiation Oncology, Odette Cancer Centre, Toronto, Canada Purpose/Objective: The role of prostate high-dose-rate brachytherapy (HDR-BT) and stereotactic body radiotherapy (SBRT) in conjunction with simultaneous ultra-hypofractionated whole pelvis radiotherapy (UH-WPRT) is currently under investigation for higher risk prostate cancer. This analysis compares genitourinary (GU) and gastrointestinal (GI) toxicity and quality-of-life (QOL) between two contemporary strategies for unfavourable risk disease: (1) HDR-BT followed by ultra-hypofractionated whole pelvis radiotherapy UH- WPRT, and (2) prostate SBRT with integrated UH- WPRT. Material/Methods: Patients with NCCN-defined unfavorable intermediate or high-risk prostate cancer were enrolled in two multi-institutional trials conducted between February 2020 and October 2023. In the HOPE trial (NCT04197141), patients were randomized to HDR-BT followed by either conventionally fractionated radiotherapy (RT) or UH-WPRT. The ARGOS trial (NCT05269550) was a single-arm study delivering prostate SBRT with a simultaneous boost to the dominant intraprostatic lesion and concomitant UH- WPRT. For this analysis, patients from the UH-WPRT arms of HOPE were compared to those from ARGOS. Both trials used identical UH-WPRT protocols: nodal contours per NRG guidelines, 6 mm planning target volume (PTV) margins, and 25 Gy in five alternate-day fractions. Expanded Prostate Cancer Index Composite Short Form (EPIC-26) questionnaires and toxicity data were collected using the same follow-up visit schedule, enabling direct outcome comparison. Results: Baseline characteristics were balanced between cohorts. A total of 91 patients were included (41 from HOPE, 50 from ARGOS) and median follow-up was 3.2 and 2.2 years, respectively. Unfavorable intermediate- risk disease represented 44% (n=18) and 46% (n=23) of
Conclusion: Both ultra-hypofractionated regimens — HDR-BT followed by UH-WPRT (HOPE) and SBRT with integrated UH-WPRT (ARGOS) — were safe and well tolerated in patients with higher risk prostate cancer. Early QOL and toxicity outcomes suggest comparable tolerability supporting continued investigation. Keywords: HDR-BT, SBRT, QOL References: Mendez LC, Crook J, Martell K, Schaly B, Hoover DA, Dhar A, Velker V, Ahmad B, Lock M, Halperin R, Warner A, Bauman GS, D'Souza DP. Is Ultrahypofractionated Whole Pelvis Radiation Therapy (WPRT) as Well Tolerated as Conventionally Fractionated WPRT in Patients With Prostate Cancer? Early Results From the HOPE Trial. Int J Radiat Oncol Biol Phys. 2024 Jul 1;119(3):803-812. PMID: 38072323.Ramadan S, Loblaw
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