S739
Clinical – Lower GI
ESTRO 2026
Material/Methods: An electronic platform was developed for CITRuS1 (NCT04697394) incorporating numerous validated PROMs tools. Patients diagnosed with non-metastatic colorectal cancer deemed curative with surgery or (chemo-)radiotherapy were eligible. Demographics, tumour and treatment details were recorded on a designated database. After treatment completion, patients completed monthly PROMs questionnaires for 1 year. Longitudinal analysis assessed global health status and functional scores from EORTC-QLQ-C30 and EORTC-QLQ-CR29 across multiple timepoints. Results: 653 patients were approached, with 380 consenting (58.3%) from 26 centres. Of these; 158 had rectal cancers and 222 non-rectal cancers. The median age was 67 (range 29-95) and 240 (63.2%) were male. Treatment for non-rectal cancers included; surgery alone (152/222) or with adjuvant chemotherapy (57/222). Rectal cancer patients had more varying treatment; 40 surgery only, 19 surgery with adjuvant chemotherapy and 1 local excision. 30 had surgery after external beam radiotherapy or chemoradiotherapy +/- consolidation chemotherapy +/- adjuvant chemotherapy. The remaining 68 underwent organ preserving approaches of which 42 received contact brachytherapy. Within the first year, 37 withdrew from the study, giving a 90.3% retention rate. Monthly completion of PROMs ranged from 65.3- 72.7%. Mean global health status was worse in the rectal cohort at all time points. Similarly, all functional scores from EORTC-QLQ-C30 including; physical, emotional, role, cognitive and social function scores as well as body image score from EORTC-QLQ-CR29 were lower at all time points. At 1-month post-treatment, mean anxiety and weight scores were better in the rectal cancer cohort but thereafter was worse. This may reflect the high number of patients receiving organ-preserving regimens with chemoradiotherapy.
Conclusion: MR-guided adaptive dose-escalated radiotherapy using the MARS protocol is feasible, well tolerated and enables high rates of organ preservation in rectal cancer with maintained bowel function. Keywords: Rectal Cancer, Organ preservation, Dose escalation Digital Poster Highlight 4443 Quality of life after colorectal cancer treatment within the CITRuS1 study Thomas Maccabe 1,2 , Aspazia Spyrou 3 , Helen Minnaar 3 , Mat Trumble 4 , Mark Halling-Brown 4 , Jacqueline Steinke 3,2 , Alexandra Stewart 3 1 Department of Colorectal Surgery, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom. 2 Department of Medicine and Biosciences, University of Surrey, Guildford, United Kingdom. 3 St Luke's Cancer Centre, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom. 4 Medical Physics Computing, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom Purpose/Objective: Morbidity after colorectal cancer treatment is well known, with many not returning to their baseline level of function1. Recent oncological developments have led to more diverse treatment paradigms with varying levels of toxicity. Toxicity is often short-lived, but for many patients, effects on quality of life (QoL) can be long-lasting. Routine use of PROMs can improve patient-clinician communication and patient- satisfaction2. Electronic PROMs (ePROMs) platforms can facilitate the recording of symptoms and QoL outcomes more consistently. Temporal assessments across multiple timepoints can help identify specific times when symptoms or function deteriorate and could potentially be improved through targeted treatment-specific measures.
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