S692
Clinical – Lower GI
ESTRO 2026
C.M.; Oei, A.L.; Stalpers, L.J.A.; Bel, A.; Franken, N.A.; Kok, H.P. Thermoradiotherapy Planning:Integration in Routine Clinical Practice. Int. J. Hyperth. 2016, 32, 41– 49. Keywords: locally advanced rectal cancer, deep hyperthermia Digital Poster Highlight 1135 Decision regret in patients with rectal cancer undergoing radiotherapy Tim Werfel 1,2 , Alexander Rühle 3,4 , Clemens Seidel 3,4 , Julia Reuter 3,4 , Andreas Hinz 5,4 , Maximilian Römer 1,2 , Nils H. Nicolay 3,4 , Klaus Pietschmann 1,2 , Georg Wurschi 1,2 1 Department of Radiotherapy and Radiation Oncology, Jena University Hospital, Jena, Germany. 2 Comprehensive Cancer Center Central Germany (CCCG), Partner Site Jena, Jena University Hospital, Jena, Germany. 3 Department of Radiation Oncology, University Medical Center Leipzig, Leipzig, Germany. 4 Comprehensive Cancer Center Central Germany (CCCG), Partner Site Leipzig, University Medical Center Leipzig, Leipzig, Germany. 5 Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany Purpose/Objective: This study examines decision regret (DR) in patients with locally advanced rectal cancer (UICC II/III) undergoing multimodal treatment. We aimed to identify its prevalence and risk factors, as well as to compare DR between patients after different sequences of multimodal treatment. Material/Methods: In this bicenter cross-sectional observational study, DR was measured using the German version of the Ottawa Decision Regret Scale (DRS) (Brehaut et al., 2003). Additional validated questionnaires assessed quality of life (QoL), fear of progression (FoP) and recurrence (FoR), depression and anxiety, social support, and participation in decision-making (PDM). Spearman’s rank, Kruskal–Wallis, Mann–Whitney U, and linear regression were used for group comparisons and predictor analysis. Results: Of 263 eligible patients, 161 participated and 157 were analyzed (mean age 68.8 years, SD 9.4; 67% male). The mean interval between first radiotherapy (RT) and survey completion was 35.1 months. Overall, 76.6% underwent surgical resection and 23.4% organ- preserving treatment. DR was reported by 70.7% of patients (n = 111), with 31.8% indicating strong DR (n = 50). Median (IQR) DRS scores were 15.0 (±32.5) for RT, 15.0 (±30.0) for chemotherapy, and 20.0 (±45.0) for surgery, with no significant difference between
limited for both short-course (SCRT) and long-course (LCRT) radiotherapy (RT) regimens. This study evaluated the feasibility, tolerance, and safety of combining deep radiative HT with neoadjuvant CRT using a phased-array system in patients with LARC. Material/Methods: In this single-center prospective observational study, 67 LARC patients received neoadjuvant RT and chemotherapy combined with deep regional HT (ALBA 4D system).Patients treated with SCRT (5 × 5 Gy) were prescribed two HT sessions, while those treated with LCRT (25 × 2 Gy) were prescribed ten sessions.HT planning was performed using dedicated software with real-time thermometry for precise thermal delivery.Feasibility was defined as completion of ≥ 50% of prescribed HT sessions.Tolerance and toxicity were evaluated using standardized scales (QMHT, UMC, CTCAE v4.03). Results: HT was feasible in both groups: 100% of SCRT and 63.6% of LCRT patients completed ≥ 50% of prescribed sessions.A total of 243 sessions were delivered. Most symptoms were mild and transient, mainly localized pain. No grade ≥ 3 HT-related toxicities occurred.All patients completed the planned RT and surgery without delay.Median T50 was 40.3 °C for SCRT and 40.4 °C for LCRT, with a median RT-to-HT interval of 42 minutes in both groups.Additionally, an exploratory analysis using data from our institutional registry— including patients treated before, during, and after the implementation of hyperthermia—revealed no significant differences in the incidence or severity of acute toxicities between those treated with and without HT. Hyperthermia itself did not add systemic or gastrointestinal toxicity to chemoradiotherapy; its impact was limited to mild and transient session- related sensations (heat or pressure), further supporting its safety. Conclusion: This first Spanish experience demonstrates that deep radiative hyperthermia can be seamlessly integrated into both SCRT and LCRT neoadjuvant protocols for rectal cancer.High adherence, favorable tolerance, and reliable thermal control support its feasibility and safety.These findings, together with the absence of added toxicity, support the incorporation of regional hyperthermia into standard neoadjuvant treatment strategies. References: 1.Lukácsi, S.; Munkácsy, G.; Gy orffy, B. Harnessing Hyperthermia: Molecular, Cellular, and Immunological Insights for Enhanced Anticancer Therapies. Integr. Cancer Ther. 2024, 23, 15347354241242094.2.Kok, H.P.; Cressman, E.N.K.; Ceelen, W.; Brace, C.L.; Ivkov, R.; Grüll, H.; ter Haar, G.; Wust, P.; Crezee, J. Heating Technology for Malignant Tumors: A Review. Int. J. Hyperth. 2020, 37, 711–741.3.Crezee, H.; Van Leeuwen,
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