S29
Brachytherapy - Gastro-intestinal, paediatric brachytherapy, miscellaneous
ESTRO 2026
Royal Surrey NHS Foundation Trust, Guildford, United Kingdom. 3 Project manager, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom. 4 Colorectal surgery, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom. 5 Research, University of Surrey, Guildford, United Kingdom. 6 Radiotherapy, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom. 7 Scientific Computing, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom. 8 Scientific computing, University of Surrey, Guildford, United Kingdom. 9 Oncology, Clatterbridge Cancer Centre, Liverpool, United Kingdom. 10 Medical research, University of Liverpool, Liverpool, United Kingdom. 11 Oncology, Nottingham City Hospital, Nottingham, United Kingdom. 12 Oncology, Queen's Centre for Oncology and Heamatology, Castle Hill Hospital, Hull, United Kingdom. 13 Oncology, Uppsala University Hospital, Akademiska sjukhuset, Uppsala, Sweden. 14 Medica research, University of Surrey, Guildford, United Kingdom
involving pediatric oncologists, radiation oncologists, surgeons, radiologists, and nuclear medicine specialists. Each case was discussed before treatment to define the optimal strategy and evaluate indications for combined external beam radiotherapy (EBRT) and/or brachytherapy, in integration with surgery. For eligible patients, a joint preoperative planning meeting was held between the referring center and the treating radiation oncologist to review imaging and define catheter positioning. During surgery, the radiation oncologist participated onsite. Postoperatively, patients remained hospitalized at the pediatric institution and were transported daily by ambulance to the radiotherapy unit for treatment delivery. When multiple applications were needed, the immersive room environment was used to ensure comfort and emotional well-being during hospitalization.Between April 2023 and September 2025, ten pediatric patients were treated with IRT, including five head and neck cases and five pelvic cases. The most frequent diagnoses were orbital and prostatic sarcomas. In orbital sarcomas, conservative surgery preserving the ocular globe was followed by catheter placement and IRT (total dose 32 Gy in 4 Gy fractions, twice daily). In prostatic sarcomas, prostatectomy with bladder neck preservation was followed by IRT (total dose 36 Gy in 3 Gy fractions, twice daily). Follow-up imaging was discussed during subsequent multidisciplinary boards, ensuring continuous evaluation and shared decision- making. Conclusion: The implementation of a structured pediatric brachytherapy pathway enabled the integration of multiple disciplines and institutions, ensuring treatment feasibility, patient-centered care, and knowledge transfer between high-volume centers. Clearly defined roles, shared protocols, and continuous communication proved essential to the success and sustainability of this collaborative model. Keywords: Paediatric. Multidisciplinary. Interventional. Mini-Oral 5142 Beyond OPERA-A multi-institutional analysis of patients treated with contact X-Ray brachytherapy(CXB) for locally advanced or metastatic rectal cancer Aspazia Spyrou 1 , Matthew Trumble 2 , Helen Minnaar 3 , Tom Maccabe 4,5 , Ciarna Brooker 6 , Mark Halling- Brown 7,8 , Sun Myint 9,10 , Rajaram Sripadam 9 , Jamie Mills 11 , Amandeep Dhadda 12 , Andrew I Hunter 12 , Joakim Folkesson 13 , Calin Radu 13 , Alexandra J Stewart 1,14 1 Oncology, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom. 2 Scientific computing,
Purpose/Objective: The OPERA trial1 demonstrated a significant
improvement in rates of organ preservation for early rectal cancer patients using a CXB boost within a non- operative treatment approach. However, there is a paucity of evidence for the use of CXB in more advanced rectal cancer. Therefore, we present outcomes of patients with advanced rectal cancer treated with CXB from an international cohort. Material/Methods: 245 patients were identified from five UK and international institutions using the Guildford database. Patients had tumour stage T3c/T3d or T4, any N, or any T stage and N2 or metastatic rectal cancer and were treated with CXB as part of an organ preservation approach. Prospectively collected response data are presented. Results: The median age at diagnosis was 74 years (range 33- 99). The median follow-up was 36 months (range 12- 72). The TNM staging is presented in table 1. 47% of patients were fit for surgery, 18% were high risk but operable and 22% were medically inoperable (n=32 surgical fitness not available). Response data were available for 167 patients, 115(69%) had a complete or near complete clinical response (cCR/nCR), 9 (5%) had partial response and 43 (26%) had persistent disease. The local recurrence rate was 39% (45/115). 106/167 patients (63%) were operable and from those 71/106 (67%) achieved CR/nCR. 35/106 (33%) had local regrowth/recurrence. Conclusion: Although surgery remains the gold standard for optimal local control, for those patients with advanced or metastatic rectal cancer not willing for surgery or not medically fit, the use of CXB can provide a clinically
Made with FlippingBook - Share PDF online