S27
Brachytherapy - Gastro-intestinal, paediatric brachytherapy, miscellaneous
ESTRO 2026
Boost After External Beam Radiation Therapy in Elderly or Medically Inoperable Patients With Rectal Cancer : Phase 1 HERBERT Study. Radiat Oncol Biol 2017;98(4):908–17.3. Than NW, Pritchard DM, Hughes DM et al. Neoadjuvant (Chemo)Radiation in High-Risk Locally Advanced Rectal Cancer. Int J Radiat Oncol Biol Phys. 2025 Jul 1;122(3):709-7204. Garant A, Vasilevsky CA, Boutros M et al MORPHEUS Phase II-III Study: Cancers (Basel). 2022 Jul 28;14(15):3665. Digital Poster Highlight 4357 Quality of life after salvage Surgery following contact brachytherapy Thomas Maccabe 1,2 , Aspa Spyrou 3 , Helen Minnaar 3 , Mat Trumble 4 , Mark Halling-Brown 4 , Andrea Scala 1 , Tim Rockall 1 , Alexandra Stewart 5,2 1 Department of Colorectal Surgery, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom. 2 Section of Oncology, Department of Clinical & Experimental Medicine, University of Surrey, Guildford, United Kingdom. 3 St Luke's Cancer Centre, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom. 4 Medical Physics Computing, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom. 5 St Luke's Cancer Centre, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom Purpose/Objective: There are an increasing number of patients receiving organ preservation regimens for rectal cancer1. Contact brachytherapy (CXB) has been shown to improve rectal preservation avoiding permanent stomas2. However, surgery may still be necessitated if there is persistent disease or local regrowth, usually with an abdominoperineal resection (APR). Quality of life (QoL) studies through patient-reported outcome measures (PROMs) after salvage surgery when organ preservation fails can help guide clinicians and patients within a shared decision-making process. Material/Methods: Patients requiring rectal resection due to ‘persistent disease’ or ‘local regrowth’ after CXB for rectal cancer from a single UK centre were identified from a prospectively kept database. Demographics and surgical details were collated. PROMs questionnaires; EORTC-QLQ-C30, EORTC-QLQ-CR29 and a Decision Regret Scale (DRS) were sent to assess global QoL, functional scores and symptom scales, all scored out of 100. Higher functional scores suggest with better function, conversely higher symptom scales refer to worse symptoms. Results: 424 patients received CXB for rectal cancer between 2014-2024. Of these, 64 received salvage surgery. 46
negative had significantly better response/Late rectal toxicity grade 2 and grade 3 was seen in 13(40%) 5(15.6%) of patients
Conclusion: Dose escalated MRI guided endorectal brachytherapy using Ir 192 post NACTRT is safe and leads to significant downstaging of tumour, enabling organ preservation, with salvageable regrowth rate and acceptable toxicity in locally advanced low lying rectal cancers.CTRI reg no 2020/03/023943 Keywords: Organ preservation Rectal cancer References: 1.Appelt AL, Pløen J, Harling H, Jensen FS, Jensen LH, Jørgensen JCR, et al. High-dose chemoradiotherapy and watchful waiting for distal rectal cancer : a prospective observational study. :919–27. 2 Rijkmans EC, Cats A, Nout RA,et al. Endorectal Brachytherapy
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