S28
Brachytherapy - Gastro-intestinal, paediatric brachytherapy, miscellaneous
ESTRO 2026
R, Baudin G, Evesque L, Dhadda A, Sun Myint A, Gérard JP, Doyen J; ICONE group. A phase III randomised trial on the addition of a contact X-ray brachytherapy boost to standard neoadjuvant chemo-radiotherapy for organ preservation in early rectal adenocarcinoma: 5 year results of the OPERA trial. Ann Oncol. 2025 Feb;36(2):208-215. doi: 10.1016/j.annonc.2024.10.827. Epub 2024 Nov 10. PMID: 39532203.
were still alive and sent questionnaires. 23 responded (50%), 18 male, 5 female. Median age at diagnosis was 68 (range 52- 86). 18 required surgery after local regrowth and 5 with persistent disease. One underwent an anterior resection with a colostomy, 20 APR and 2 exenterations. Mean time from surgery to PROMs was 3.5 years (range; 0.8-10.1). Three developed distant metastases since surgery. Mean global quality of life score 64.4 (sd=23.6). EORTC-QLQ- C30 physical, role, emotional, cognitive and social functional scores ranged between 77.3-83.3. Similarly, EORTC-QLQ-CR29 anxiety, body image and weight scores ranged between 75.4-84.1. These matched EORTC-QLQ- C30 reference values for colorectal cancer patients; global score (60.7) and functional scores between 68.9- 85.2. Urinary frequency and impotence were the most troublesome symptoms with mean scores of 41.3 and 66.7. There was a low level of stoma- related symptoms reported; including stool frequency, flatulence, peristomal skin soreness, stoma trouble or embarrassment, with mean scores of 17.4, 24.6, 13.6, 5.8 and 17.4 respectively. Mean DRS score was 28.0/100 (sd=30.7), indicating low levels of regret about CXB. Linear regression analysis only identified distant metastases to affect cognitive function, body-image and weight scores. No factors were associated with global QoL, other functional or decision regret including CXB treatment, operation type, disease recurrence or time from surgery.
Digital Poster 5092 SMART: a Structured Multidisciplinary Approach
for building an integrated paediatric interventional radiotherapy workflow
Bruno Fionda 1 , Elisa Meldolesi 1 , Giuseppe Maria Milano 2 , Alessandro Crocoli 3 , Elisa Placidi 4 , Enrico Rosa 1 , Elisa Marconi 5 , Ida Russo 2 , Silvia Mariani 1 , Claudio Lafaenza 1 , Patrizia Cornacchione 1 , Maria Antonietta Gambacorta 1 , Silvia Chiesa 1 , Luca Tagliaferri 1 1 Radiation Oncology Unit, Diagnostic Imaging and Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 2 Department of Onco-hematology, Gene and Cell Therapy, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy. 3 Oncological Surgery, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy. 4 Department of Radiology and Oncological Radiotherapy, UOC Fisica per le Scienze della vita, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 5 Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy Purpose/Objective: To describe the implementation of an integrated and shared clinical pathway for pediatric oncology patients referred for interventional radiotherapy (brachytherapy, IRT) from a high-volume center, aimed at optimizing treatment coordination, patient safety,
and family support. Material/Methods:
The pathway was developed through an initial learning phase in collaboration with two senior national and international experts in pediatric brachytherapy, to acquire specific technical and organizational expertise. After the first two cases, the need for a dedicated multidisciplinary team became evident. The team included pediatric radiation oncologists, brachytherapy-dedicated radiation oncologists, pediatric oncologists and pediatric surgeons, anesthesiologists, and a psychologist providing biopsychosocial support to the patient and family. Two internal coordinators were appointed to manage workflow and communication between institutions. Results: A monthly pediatric tumor board was established,
Conclusion: Salvage surgery after failed organ preservation does not appear to impact QoL unless recurrence occurs after surgery, however bladder and sexual dysfunction remain commonplace. Keywords: Salvage Surgery, PROMs, Contact Brachytherapy References: National Bowel Cancer Audit (NBOCA) State of the Nation Report, October 2025 London: NBOCA State of the Nation Report 2025 - National Cancer Audit Collaborating Centre Baron D, Pace Loscos T, Schiappa R, Barbet N, Dost E, Ben Dhia S, Soltani S, Mineur L, Martel I, Horn S, Picardi C, Stewart A, Cotte E, Coquard
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