ESTRO 2023 - Abstract Book

S454

Sunday 14 May 2023

ESTRO 2023

Conclusion In patients with prior TURP, moderate or extreme hypofractionated prostate RT did not result in excessive or long-lasting toxicity. PD-0573 MR-guided daily adapted SBRT for prostate cancer: Acute and late patient reported outcomes K. Nugent 1,2 , A. Sabharwal 3 , C. Perna 3 , P. Das 4 , N. Dallas 5 , P. Camilleri 5 1 Genesiscare, Radiation Oncology, Oxford, United Kingdom; 2 Genesiscare, Radiation Oncology, Oxford, Ireland; 3 Genesiscare, MRI Linac, Oxford, United Kingdom; 4 Genesis Care, MRI Linac, Oxford, United Kingdom; 5 GenesisCare, MRI Linac, Oxford, United Kingdom Purpose or Objective To record patient reported GI & GU adverse events (PRO CTC AE), in the acute and late effects setting, amongst prostate cancer patients who underwent MRI-guided adaptive SABR. Materials and Methods Patients who completed a baseline 12 item PRO-CTC AE (AE), before undergoing 36.25 Gy in 5 fractions by MRI-guided adaptive SABR, were subsequently followed up with the same graded questionnaire: none; mild/rarely; moderate/occasionally; severe/frequently; very severe/almost constantly at set time points. Latest PSA levels was recorded. The % of patients who reported no change from their baseline AE or reported a new ≥ ‘frequent’ or’ severe’ AE grade during follow up was calculated. For individual patients, the maximum AE grade for each PRO-CTC AE item was recorded. The % of toxicity levels for each separate AE item at set time points were calculated. Results Median follow-up was 27 months (range: 6-34 months) for 69 patients (median age 73). The median pre-RT PSA was 7.5 mmol/l (4.5-32 mmol/l), median T Stage T2b (T0-T3b) and the median Gleason Score of 7 (3+4, range: 6-9). 29% of patients were in the high-risk category. No patient had biochemical failure (median PSA 0.42) at time of follow up. In the CTC PRO AE GI categories, most men reported no change from baseline toxicity level in the follow up period; diarrhoea 84%, constipation 84%, faecal incontinence 81%, pain on opening bowels 72%, general pain 83%, GI bleeding 88%. There was no new “frequent” GI bleeding. 45% of patients reported at worst some mild or moderate diarrhoea (Fig 1) with new ≥ “severe” diarrhoea reported in 9% of patients (Tab.1) peaking at 24 months but absent at > 33 months (Fig. 2.1). Similarly, in the urinary AE categories, apart from urinary urgency, >80% of men reported no change from baseline toxicity during follow up. 20% of men reported ≥ “frequent” urinary urgency with incidence peaking during the first month follow up but absent in patient reporting at >33 months (Fig 2.2). No man reported new “frequent” blood in urine at any point. 7% of men reported ≥ “quite a bit” of urine leakage during follow up peaking as a late effect during the 13–19-month period (Fig 2.4). New “severe” sexual dysfunction was seen in 25% of patients and was persistent at > 33 months with 68% of patients having received ADT.

PRO-CTC AE (AE)

No increase in AE Grade from Baseline New ≥ “Frequent or Severe” AE reported

Diarrhoea

n=58 (84%) n=58 (84%) n=56 (81%) n=50 (72%) n= 57 (83%) n=61 (88%) n=56 (81%)

n=6 (9%) n=2 (3%) n=1 (1%) n=4 (6%) n=4 (6%) n=0 (0%) n= 2 (3%)

Constipation

Faecal incontinence Pain on opening bowel

General pain GI bleeding

Painful urination