S980
Clinical - Oligometastatic cancer
ESTRO 2026
France. 3 Radiation Oncology, University of California, Los Angeles, USA
radiotherapy. The FBCT-integrated uRT-linac 506c (United Imaging Healthcare Co., LTD, Shanghai, China) with its intelligent treatment planning system was used in the study. Clinical data, including baseline information, treatment plans, and follow-ups, were collected and analyzed for 17 patients. The one-stop workflow includes FBCT simulation, auto-contouring of gross tumor volume (GTV), autosegmentation of organs-at-risk (OARs), auto-planning, and delivery of external beams. Manual quality assurance and quality control were required before forwarding to the next step in the treatment protocol. The simultaneous integrated boost volumetric modulated arc therapy was applied with a total dose of 30Gy in 10 fractions for the planning target volume (PTV) and a total dose of 48Gy in 12 fractions for the boosted planning gross target volume (PGTV). The constraints of OARs varied with the lesions' locations, with the maximum equivalent dose in 2Gy fractions (EQD2) of the spinal cord strictly under 45Gy. Results: The average duration of the whole procedure is 43.39 ± 9.80 minutes (30.67 -74.4 minutes). The median duration is 45.18 minutes (interquartile range: 35.76- 45.71 minutes). The average follow-up time is 11 months (range: 2 –19 months). The pain-relief rate at one month post-radiation is 88.23% (15/17). The neurologic symptom relief rate at three months post- radiation is 72.7% (8/11). The local control rate at one month post-radiation is 100% (17/17). No patients exhibited acute radiation myelitis or acute radiation radiculitis at three months post-radiation (0/16), and no chronic radiation-related adverse effects were observed at six months post-radiation (0/14). Conclusion: This study demonstrated that FBCT-guided AIO emergency radiotherapy is a practical and safe option for patients with metastatic vertebral malignancies. The applied radiation dose achieved a reasonable local control rate and symptom relief rate, while no adverse effects were observed under a strict constraint on major OARs. Keywords: Metastasis, Radiotherapy, All-in-one platform Surgery or SABR for adrenal metastases? A dual systematic review and meta-analysis of 115 studies and 5533 patients Nicolas Giraud 1,2 , Peter S.N. van Rossum 1 , Sasha Ebrahimi 3 , Miguel A. Palacios 1 , Drew Moghanaki 3 , Famke L. Schneiders 1 , Suresh Senan 1 1 Radiation Oncology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands. 2 Radiation Oncology, CHU Bordeaux, Bordeaux, Digital Poster Highlight 3396
Purpose/Objective: Adrenal oligometastases are increasingly treated using local therapies but no randomized trial has yet compared adrenalectomy and stereotactic ablative radiotherapy (SABR). We report on the largest dual systematic review and meta-analysis comparing the oncologic outcomes and safety of both modalities in order to identify factors influencing treatment results. Material/Methods: Following PRISMA guidelines (PROSPERO CRD420251071902), PubMed and EMBASE were searched (1999-08/2025) for studies reporting oncologic outcomes or adverse events after adrenalectomy or SABR for adrenal metastases performed with local ablative, curative or radical intent (total adrenalectomy with objective of clear margins or hypofractionated ≥ 5 Gy per fraction SABR). Excluded were series with <5 patients, overlapping cohorts and conference abstracts. Co-primary endpoints were local control (LC) and treatment-related adverse events (all- grade and grade ≥ 3, using Dindo-Clavien or CTCAE). Pooled proportions were estimated using generalized linear mixed models with random effects. Univariable and multivariable meta-regressions explored associations between outcomes and clinical or technical factors. Risk of bias was assessed with ROBINS-I. Results: A total of 115 retrospective studies (5533 patients: 3929 adrenalectomy, 1904 SABR) were included. Overall, 38% of studies were at moderate risk, and 57% at high risk of bias per ROBINS-I, mainly due to retrospective design and heterogeneous patient selection. Median age and sex distribution were similar between adrenalectomy and SABR cohorts, with lung cancer predominating in SABR studies, whereas melanoma, renal cell carcinoma, and colorectal cancer being more frequent in adrenalectomy series. Both approaches achieved high LC (adrenalectomy 87.1%, SABR 84.5%; Figure 1).
Made with FlippingBook - Share PDF online