S863
Clinical - Mixed sites & palliation
ESTRO 2026
achieving initial pain relief in > 90% of patients with a median latency of 12 weeks. The median time to pain recurrence was 34 months. Besides clinical and treatment planning parameters, treatment delivery duration was found to influence both efficacy and toxicity outcomes. Keywords: CyberKnife, Trigeminal Neuralgia, Radiosurgery
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Loss of psoas muscle, an indicator of sarcopenia, is a strong predictor of acute anorexia in abdominal palliative radiotherapy: A 9-year IPTW analysis Aiko Nagai 1 , Natsuo Tomita 2 , Seiya Takano 2 , Yusuke Nakashima 1 , Shingo Uchikura 3 , Akio Hiwatashi 2 1 Department of Radiation Oncology, Nagoya City University East Medical Center, Nagoya, Japan. 2 Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 3 Central Radiology Department, Nagoya City University East Medical Center, Nagoya, Japan Purpose/Objective: Sarcopenia, a condition characterized by reduced skeletal muscle volume loss and strength, is known to affect treatment outcomes and toxicities in cancer therapy [1]. However, its clinical relevance in palliative radiotherapy remains unclear [2,3]. This study aimed to investigate the association between acute gastrointestinal (GI) toxicity - an important cause of treatment interruption - and both psoas muscle area loss and dosevolume histogram (DVH) parameters in patients receiving abdominal palliative radiotherapy. Material/Methods: We retrospectively screened 1,075 patients who underwent abdominal or pelvic palliative radiotherapy for malignant tumors at Nagoya City University East Medical Center between 2014 and 2022. Among them, 144 patients met the eligibility criteria and were included in the analysis. Palliative radiotherapy was defined as treatment with an equivalent dose in 2 Gy fractions (EQD2) of ≤ 50 Gy. The psoas muscle index (PMI) was calculated from treatment planning CTimages for radiation therapy at the third lumbar vertebra (L3) level by dividing the bilateral psoas muscle area (cm ² ) by the height squared (m ² ) (Figure1). Patients were then classified into the low PMI group and the normal PMI group using cut-off values of 6.0 cm ² /m ² for males and 3.4 cm ² /m ² for females.The primary endpoint was acute GI toxicity, including anorexia, diarrhea, and nausea. Inverse probability of treatment weighting (IPTW) was applied based on
A linear function between IBED and ID was observed (Figure). Over a median follow-up time of 48 months (range: 3-175), 91% of patients achieved initial pain relief (BNI I–IIIa) after a median latency of 12 weeks.
At the last follow-up, overall pain control was maintained in 71% of patients, with a median time to recurrence of 34 months. Onset of BNI III-IV facial numbness occurred in 8% of patients. Univariate Cox proportional hazards analysis demonstrated that pain relief duration correlated with target volume, prescription isodose line, maximum dose, ID, beam on time, IBED, presence of a vessel at nerve and pain relief latency. Probit univariate analysis indicated that onset of BNI IV facial numbness was associated with lower prescription isodose, larger target volume, higher ID and IBED, and pain relief latency < 4 weeks. Conclusion: CKRS is a safe and effective treatment option for TN,
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