S407
Clinical - Gynaecological
ESTRO 2026
Unit, Department of Oncology, “Santa Maria della Misericordia” University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy. 11 Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Rozzano, Italy. 12 Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy. 13 radiation Oncology Center, S Maria Hospital, Terni, Italy. 14 Radiation Oncology, Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy. 15 UOC di Radioterapia, Ospedale Isola Tiberina – Gemelli Isola, Rome, Italy. 16 UOC di Ginecologia Oncologica, Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Rome, Italy. 17 Istituto di Radiologia, Università Cattolica del Sacro Cuore Roma, Rome, Italy Purpose/Objective: To analyze the subgroup of oligometastatic ovarian cancer patients from the large prospective MITORT3/RAD study [1,2] who underwent Stereotactic Body Radiotherapy (SABR) and had received bevacizumab treatment. Material/Methods: A pooled analysis, focusing on oligometastatic OC patients who received Stereotactic Body Radiotherapy treatment and bevacizumab within 12 months prior to radiotherapy (RT), was performed. The toxicity profile, together with the response and outcomes, was then evaluated. Results: Among 219 patients included in the database, 41 patients accounting for 68 lesions were included in the analysis. 26 patients were previously treated with more than one systemic regimen. All patients received bevacizumab within 12 months before Stereotactic Body Radiotherapy: in particular, 23 patients up to 3 months before and the others up to 12 months before. Only one patient had received a previous RT treatment. Of the 68 lesions, 44 were lymph
nodes and 24 parenchymal ones, mainly located in the abdominal (27/68), pelvic (20/68), and thoracic (11/68) districts. Doses ranged from 20 Gy in a single fraction to 50 Gy in 5 fractions according to the site of metastases and constraints to organs at risk. Only eight patients experienced 15 acute toxicities, all of which were below grade 3. The most common were upper gastrointestinal issues (4), pain (4), and asthenia (3). Only one late toxicity was reported: a grade 2 intestinal sub-occlusion in a patient treated with Stereotactic Body Radiotherapy for two abdominal nodal lesions, receiving 40 Gy in 5 fractions. With an actuarial median follow-up of 28 months (IC95% 20.0-35.4 months), we registered a one- and two-year Local Control of 82.2% and 73.3%, respectively. Conclusion: Stereotactic Body Radiotherapy delivered within 12 months of bevacizumab appears safe and well tolerated in oligometastatic ovarian cancer, with no grade ≥ 3 toxicities and preserved quality of life. These results address a major gap and support Stereotactic Body Radiotherapy as a potential therapeutic option in this challenging setting. References: 1.Macchia G, Pezzulla D, Campitelli M, et al Treatment of Oligometastatic Parenchymal Lesions in Ovarian Cancer With Stereotactic Ablative Radiation Therapy: A Multicenter Prospective Phase 2 Trial (MITO RT3/RAD). Int J Radiat Oncol Biol Phys. 2025 Sep 1;123(1):228-237. doi: 10.1016/j.ijrobp.2025.03.032. Epub 2025 Mar 31. PMID: 40174649.2. Macchia G, Campitelli M, Pezzulla D, et al. Stereotactic Ablative Radiation Therapy for Oligometastatic Ovarian Cancer Lymph Node Disease: The MITO-RT3/RAD Phase II Trial. Int J Radiat Oncol Biol Phys. 2025 Mar 1;121(3):693-702. doi: 10.1016/j.ijrobp.2024.09.036. Epub 2024 Sep 24. PMID: 39326506. Keywords: Ovarian Cancer, Bevacizumab, SBRT
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