S714
Clinical – Lower GI
ESTRO 2026
Material/Methods: The development of the QLQ-ANL27 followed the rigorous guidelines of the EORTC Quality of Life Group Module Development Guidelines [1] and places people with anal cancer at the centre of the work. For the final validation stage, people with anal cancer were recruited from 15 countries to complete the QLQ-C30 and QLQ-ANL27 and provide feedback on the QLQ- ANL27. Item responses, scale structure and sensitivity of the QLQ-ANL27 were evaluated. Results: Data from 382 people were included in the analyses. The QLQ-ANL27 was acceptable, comprehensive, and easy to complete. Psychometric analyses supported the items and reliability (Cronbach’s alpha ranging from 0.71 to 0.93 and test-retest coefficients above 0.7) and validity of the scales (particularly non stoma bowel symptoms and pain/discomfort). Most scales distinguished people according to treatment phase and performance status. Bowel (non-stoma), pain/discomfort and vaginal symptoms were sensitive to deteriorations over time. The QLQ-ANL27 [2] incorporates five multi-item scales to assess bowel symptoms (non-stoma), bowel symptoms (stoma), pain/discomfort, stoma care and vaginal symptoms, as well as nine single items assessing urinary frequency, swelling in legs/ankles, need to be close to toilet, clean yourself more often, planning activities, sex life, sexual interest, painful intercourse and erectile problems. Conclusion: The QLQ-ANL27 is the world’s first validated HRQoL questionnaire for people treated with CRT for anal cancer. It is available in 16 languages and has been widely accepted within the scientific community for use in clinical trials, research and clinical practice. References: 1. Wheelwright S, Bjordal K, Bottomley A, Gilbert A, et al., on behalf of the EORTC Quality of Life Group, EORTC Quality of Life Group Guidelines for Developing Questionnaire Modules. 2021. Accessed 10 November 2025.2. Sodergren SC, Johnson CD, Gilbert A, Darlington AS, ..... Vassiliou V; European Organisation for Research and Treatment of Cancer Quality of Life Group. International Validation of the EORTC QLQ- ANL27, a Field Study to Test the Anal Cancer-Specific Health-Related Quality-of-Life Questionnaire. Int J Radiat Oncol Biol Phys. 2023 Apr 1;115(5):1155-1164 Keywords: Anal cancer, Radiochemotherapy, Quality of Life
Angela Romano 1 , Giuditta Chiloiro 1 , Alessandra Castelluccia 2 , Katherine Pellegrino 3 , Luca Boldrini 1 , Carlo Guglielmo Cattaneo 4 , Matteo Galetto 1 , Flavia De Giacomo 1 , Natalia Barogi 4 , Matteo Nardini 1 , Giulia Panza 1 , Lorenzo Placidi 1 , Piercarlo Gentile 5 , Maria Antonietta Gambacorta 1 1 Department of Diagnostic Imaging and Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 2 Department of Radiation Oncology, Perrino Hospital, Brindisi, Italy. 3 Department of Radiation Oncology, Università degli Studi di Roma Tor Vergata, Rome, Italy. 4 Department of Diagnostic Imaging and Radiation Oncology, Università Cattolica del Sacro Cuore, Rome, Italy. 5 Department of Radiation Oncology, San Pietro Hospital Fatebenefratelli, Rome, Italy Purpose/Objective: Locally recurrent rectal cancer (LRRC) remains a major therapeutic challenge, particularly in previously irradiated patients, where surgical options are often limited or associated with significant morbidity. Reirradiation in this setting is technically demanding due to cumulative dose constraints and the proximity of critical organs at risk (OARs). MRI-guided radiotherapy (MRIgRT) provides superior soft-tissue contrast and enables daily online adaptive radiotherapy (oART), potentially improving target accuracy while reducing exposure to OARs during pelvic reirradiation. This multicentric retrospective study aimed to evaluate the feasibility, safety, and clinical outcomes of MRIgRT for LRRC in previously irradiated patients, with a focus on adaptive workflow utilization and treatment-related toxicity. Material/Methods: Twenty patients with previously irradiated LRRC treated with MRIgRT at two Italian centers between July 2017 and October 2024 were included. Recurrences were classified according to the Royal Marsden classification. Treatments were delivered using a 0.35 T MR-linac (MRIdian, ViewRay) with two regimens: conventional chemoradiation (CRT), with concurrent fluoropyrimidines) or stereotactic body radiotherapy (SBRT). Tumor response was assessed per RECIST 1.1. Objective response rate (ORR) was defined as complete plus partial responses (CR + PR), and disease control rate (DCR) as CR + PR + stable disease (SD). Toxicities were graded using CTCAE v5.0. Local control (LC), progression-free survival (PFS), and overall survival (OS) were estimated using the Kaplan– Meier method. Results: All patients completed MRIgRT without treatment interruptions. Acute toxicity was mild, with Grade 1–2 events in 40% of patients and no Grade ≥ 3 or late toxicity observed. oART was applied in 8 patients
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MRI-guided Reirradiation for Locally Recurrent Rectal Cancer: A Multicentric Retrospective Analysis
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