S934
Clinical - Mixed sites & palliation
ESTRO 2026
the field’s feasibility and clinical potential. The community should strive to keep this momentum and expand the clinical trials activity to multi-center and adequately powered randomized trials to prove clinical benefit and define where ART truly improves outcomes. References: 1.Heukelom J, Fuller CD. Head and Neck Cancer Adaptive Radiation Therapy (ART): Conceptual Considerations for the Informed Clinician. Semin Radiat Oncol. 2019;29(3):258-273. doi:10.1016/j.semradonc.2019.02.008 *Contributed equally Keywords: adaptive radiotherapy, MRI-guided radiotherapy, Stratification of patients who benefit from SRS/SRT to multiple metastases and multiple courses of treatment Amy Colori 1 , John Conibear 2 , Heather Doyle 1 , Bryn Jones 2 , Ankuree Patel 1 , Carolyn Minerve 1 , Ben Earner 1 , Ian Cowley 1 , ania Turlej 1 , Reisha Fuzarally 1 , Rory O'Hanlon 1 , Yasmin Shah 1 , Amen Sibtain 2 , Hamoun Rozati 2 1 Gamma Knife, HCA, London, United Kingdom. 2 Radiotherapy, HCA, London, United Kingdom Purpose/Objective: SRS/SRT has been used for smaller numbers of metastases for 20 years. NHS commissioning does not specify a maximum, instead limiting total volume to 20cm3 , but centres have been historically cautious irradiating larger numbers. Treating greater numbers has become more commonplace but not without controversy, in absence of trial evidence. We have considerable experience both safely treating greater number of metastases; and irradiating patients with multiple courses. This retrospective analysis evaluates outcomes following SRS/SRT and reviews the characteristics of patients who have undergone multiple courses of treatment Material/Methods: Digital Poster 5071 Understanding SRS for brain metastasis: This single-centre study retrospectively evaluated clinical outcomes of 235 patients SRS/SRT between 2012-23, patient demographics, tumour type/characteristics, number/volume of brain metastases, treatment characteristics using medical records. Additionally, 387 SRS/SRT encounters between 2020-25 were assessed to understand factors influencing which patients undergo multiple courses of SRS/SRT.
Conclusion: ART research is gaining momentum, with a growing number of trials across tumor sites and modern online workflows. This trend reflects early efforts in systematic technology assessment and underscores
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