S165
Brachytherapy - Urology
ESTRO 2026
The current workflow, developed and refined over the course of treating six patients, is presented in Figure 1. All patients had achieved local disease control at the time of reporting. Conclusion: Intraluminal HDR 192Ir brachytherapy offers a feasible organ-preserving alternative for selected patients with recurrence of panurothelial carcinoma in the remaining penile urethra after cystoprostatectomy. The technique enables delivery of ablative doses while maintaining an acceptable skin dose and may expand management options for this rare clinical scenario. Keywords: penile recurrence, panurethral carcinoma References: [1] Strouthos I, Tselis N, Ferentinos K, Karagiannis E, Milickovic N, Chatzikonstantinou G, Feder O, Zamboglou N Intraluminal high-dose-rate brachytherapy-An alternative organ-preserving approach for primary male urothelial carcinoma with panurethral involvement (2020) Pract Rad Oncol10 e53-e56[2] Merten R, Strnad V, Karius A, Lotter M, Kreppner S, Schweizer C, Fietkau R, Schubert P Definite treatment for primary urethral cancer: A single institution’s experience with organ-preservin brachytherapy (2025) Brachyther24 62-67 Radiotherapy Combined with High-Dose-Rate Brachytherapy Boost in Intermediate- and High- Risk Prostate Cancer Kerem Tuna Tas 1 , Tristan Spartmann 1 , Edgar Smalec 1 , Philipp Lishewski 1 , Fatima Frosan Sheikhzadeh 1 , Klemens Zink 1 , Johannes Huber 2 , Ahmed Gawish 1 , Sebastian Adeberg 1 1 Radiation Oncology, Marburg University Hospital, Marburg, Germany. 2 Department of Urology, Heidelberg University Hospital, Heidelberg, Germany Purpose/Objective: For intermediate- and high-risk prostate cancer, dose escalation is essential to optimize oncological control. While external beam radiotherapy (EBRT) alone can be limited by dose constraints to adjacent organs-at-risk, high-dose-rate (HDR) brachytherapy provides a highly conformal boost option. Material/Methods: This retrospective single-institution study analyzed 250 patients with localized intermediate- and high-risk prostate cancer treated between 06/2004 and 03/2024 with EBRT plus HDR brachytherapy boost. The EBRT dose averaged 50.4 Gy (range: 45–64 Gy), followed by HDR boost in nearly all patients (98.8%) with two fractions of 9 Gy. Androgen deprivation therapy (ADT) was administered to 39.2% of patients (98/250). Digital Poster 1817 Long-Term Outcomes of External Beam
Digital Poster 1673 Intraluminal 192Ir High–Dose–Rate brachytherapy for recurrence of urothelial carcinoma in the penile urethra Enrique Castellanos 1 , Maria Persson 2 , Karl Svennersten 1 , Åsa Carlsson Tedgren 2 1 Urology-Theme Cancer, Karolinska University Hospital, Stockholm, Sweden. 2 Nuclear Medicine and Medical Physics, Karolinska University Hospital, Stockholm, Sweden Purpose/Objective: Panurothelial carcinoma is a rare malignancy with a propensity for multifocal recurrence throughout the urothelium. Following cystoprostatectomy, recurrence in penile urethra may occur. Standard management is surgical penile amputation, but some patients decline this option. In the absence of the urinary bladder, the urethra is no longer a functional organ, allowing delivery of relatively high fraction doses, with the skin as the primary organ of interest. High dose-rate 192-Ir brachytherapy for primary urethral cancer has been described [1], [2] however, to our knowledge, this is the first description of its use in the relapse setting. Material/Methods: Six patients with penile urethral relapse who refused surgical amputation were referred to the brachytherapy department after discussion at a multidisciplinary tumor board. On the day of treatment, tumor extent and location were defined by cystoscopic examination, and gold markers were placed to delineate visible lesions. In the same session, a urethral catheter and a brachytherapy catheter were inserted into the urethra based on the endoscopic findings, followed by CT-based treatment planning. The entire urethra was treated, with focal dose escalation to regions with macroscopic recurrence. The treatment was delivered over one week, in nine fractions of 6 Gy, twice daily. Prescription depths were 4.4–7 mm for the entire urethra and focally 8–10.5 mm. All depths include 2.5 mm corresponding to the ureteral catheter. Results:
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