S943
Clinical - Non-malignant & functional radiotherapy
ESTRO 2026
He received medical treatment with alpha-bloker (tamsulosin) for 20 months which was discontinued on symtomatic and radiological progression. After 8 months without treatment, he was started on silodosin which worked for 30 months. On further progression, TURP was offered which he declined. RT treatment consisted of 25Gy in 5 daily fractions (Monday–Friday) using volumetric modulated arc therapy (VMAT) on a TrueBeam linear accelerator with 6MV energy beam. Cone beam CT was performed before each fraction. Clinical target volume was prostate + 3mm. RT mean dose to critical organs (Dmean) was as follows; sigmoid colon 0.9Gy, right femur 6.0Gy, rectum 2.8Gy, left femur 5.5Gy, urethral bulbus 1.3Gy and bladder 5.7Gy. Figure1 demonstrates the dose distribution. Patient was given dexamethasone 8mg/day for 7 days starting on day one of RT; the dose was then reduced to 4mg/day for another 7 days and then it was stopped.
in 8 patients with varying locations on the nerve. The median BNI pain score was 5 (range 4-5) pre- treatment. The median target volume was 0.06cc (IQR 0.05-0.07cc). The median brainstem maximum dose was 27.15 Gy, and the median mean and maximum doses to the ipsilateral Meckel’s cave was 8.22 Gy and 24.66 Gy respectively. The median BNI pain score after treatment was 3 (IQR 2-3) and BNI facial numbness score 1 (IQR 1-3). One patient had BNI score IV for facial numbness. The median time to initial pain relief was 6 weeks, and facial numbness started 6 months post-SRS. No patient had corneal dryness or anesthesia dolorosa. Two patients are still on full dose of AED. One patient had no pain relief, two patients had pain relapse within 1 year, and 1 patient died due to causes unrelated to the treatment. Conclusion: Root-entry zone radiosurgery for trigeminal neuralgia provides adequate symptom relief with acceptable toxicities and dosimetric profile. Keywords: trigeminal neuralgia, root entry zone, SRS Radiotherapy for benign prostatic hyperplasia (BPH): A first-in-human self-experimental case report with 24-months follow-up Josef Kovarik 1 , Muhammad Shahid Iqbal 1 , Jakub Cvek 2 , Frantisek Aigl 3 , Nick West 1 , Charles Kelly 1 1 Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. 2 Department of Oncology,, University of Ostrava, Ostrava, Czech Republic. 3 Department of Urology, SPEA Olomouc, Olomouc, Czech Republic Purpose/Objective: BPH is a common condition affecting older men which at present is treated surgically with transurethral resection of the prostate (TURP) or medically. Some patients with BPH are not fit to undergo TURP and cannot tolerate the medications. This often older, frail group of patients, have few further options with this condition which progressively diminishes their quality- of-life (QOL).One of the authors, had failed medical Digital Poster 1133 treatment and did not wish to risk the potential complications of TURP. After considering both, the clinical evidence for shrinkage of prostatic volume in other pelvic treatments with radiotherapy (RT)1; and the ethical implications of self-experimentation2 in undergoing prostatic RT for BPH, he underwent short course RT using a dose/fractionation, he had extensive
Results: With a follow-up of 24 months post-treatment, prostate volume had shrunk from 72.4cm3 (before RT) to 60cm3 (82.3%). International Prostate Symptom Score (IPSS) dropped from 26 (severely symptomatic) before RT to 6 (mild symptomatic). Uroflowmetry, peak flow rate (Q-max) increased from 6.2ml/s to 14.2ml/s. Results are summarised in Table1.
Conclusion: This is the first-in-human case of BPH treated with RT. The benefits and risks were carefully considered before treatment. Radiotherapy showed a positive benefit, clinically and in QOL outcome, and objectively in improved prostatic volume and function metrics. The likelihood of harm (acute5,6 and late toxicity7,8) was very low. The treatment was well tolerated, and QOL improved. References: 1. Shrinkage of non-malignant prostate gland volume after receiving incidental radiotherapy for rectal cancer. PMID:361867052. Self-experimentation and its
experience with3,4. Material/Methods:
The patient is a 64-year-old male with no relevant past medical history. He was diagnosed with BPH at age 58.
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