S900
Clinical - Mixed sites & palliation
ESTRO 2026
local control, reoperation and reirradiation rates, and radiotherapy parameters (dose,fractionation, modality, and target coverage). Studies on primary bone tumours or non-Englishpublications were excluded. Results: The search identified 440 records. Of these, 21 studies met the inclusion criteria,comprising 20 retrospective and 1 prospective cohort studies, with sample sizes ranging from 24to 245 patients. Among the 14 studies comparing postoperative RT with surgery alone, onedemonstrated improved pain, and another reported a benefit in functional outcomes. Of fivestudies evaluating local failure, only one demonstrated improved local control with postoperativeRT. Similarly, among eight studies examining reoperation rates, just one reported a reductionwhile the remainder showed no benefit. Three studies evaluated the relationship between implantcoverage and local failure, consistently showing that better coverage of the orthopaedic implantwas associated with improved local control. Two studies evaluated dose and fractionation inrelation to local control, with no positive association observed for higher biological equivalentdoses or multi-fraction regimens. Reported RT schedules most commonly ranged from 20–30 Gyin 5–10 fractions. Modern RT modalities such as intensity modulated radiation therapy (IMRT)and stereotactic body radiation therapy (SBRT) were utilised in two studies in selected patients,but the data remain limited and non- Evidence for postoperative RT in extremity bone metastases is largelyretrospective, with inconsistent effects on local control and reoperation rates and limited data onfunctional and pain outcomes. Comprehensive implant coverage appears important for localcontrol, whereas dose and fractionation show no clear effect on outcomes. Prospective,randomised studies are urgently needed to clarify the clinical role of postoperative RT and toestablish evidence-based recommendations for target coverage, dose, and treatment technique. Keywords: bone metastases, postoperative radiotherapy, comparative. Conclusion:
With predictive MU modelling ensuring safety, this workflow marks an important step toward redefining radiotherapy delivery, making rapid, adaptive, and resource-efficient treatment a clinical reality for selected palliative patients. Keywords: AI-contouring, MU predictive model, Ethos
Digital Poster 3602
Postoperative Radiotherapy for Extremity Bone Metastases: An Updated Systematic Review Henry C Y Wong 1 , Shing Fung Lee 2 , Simrit Rana 3 , Shengji Yu 4 , Xinxin Zhang 4 , Ningning Lu 5 , Zhenfeng Li 6 , Wendy Chan 7 , Kenny Kwan 8 , Shijie Yang 5 , Adrian Wai Chan 9 , Joel Finkelstein 10 , Albert Yee 10 , Edward Chow 11 1 Department of Oncology, Princess Margaret Hospital, Lai Chi Kok, Hong Kong. 2 Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore. 3 Faculty of Medicine, University of Ottawa, Ottawa, Canada. 4 Department of Orthopedics, Peking Union Medical College, Beijing, China. 5 Department of Radiation Oncology, Peking Union Medical College, Beijing, China. 6 Department of Orthopedics, Qilu Hospital of Shandong University, Shandong, China. 7 Department of Clinical Oncology, The University of Hong Kong, Pokfulam, Hong Kong. 8 Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong. 9 Department of Radiation Oncology, British Columbia Cancer Agency - Vancouver, Vancouver, Canada. 10 Division of Orthopaedics, Sunnybrook Health Sciences Centre, Toronto, Canada. 11 Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada Purpose/Objective: Surgical stabilization represents the standard of care for extremity bone metastasesassociated with impending or established pathological fractures. Clinical guidelines oftenrecommend postoperative radiotherapy (RT); however, its actual benefit remains uncertain. Thisupdated scoping review synthesises the current evidence on postoperative RT for extremity bonemetastases, with a focus on clinical outcomes and radiotherapy treatment characteristics. Material/Methods: A systematic search of Embase, MEDLINE, and Cochrane Central was conductedfrom database inception to October 25, 2025. In addition, a hand search of the reference lists ofincluded studies was performed. Studies were included if they reported (1) radiotherapytreatment characteristics or (2) outcomes following surgery plus postoperative RT, with orwithout comparison to surgery alone. Outcomes of interest included pain control, functionalrecovery,
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Important issues from healthcare professional and patient perspectives regarding the quality of life in bone metastases Britney Zhang 1 , Shely Kagan 1 , Christina Yang 1 , Shivani Verma 1 , Sarah Bayrakdarian 1 , Caroline Hircock 2 , Hany
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