ESTRO 2023 - Abstract Book

S1250

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ESTRO 2023

Purpose or Objective Hypofractionation (HF) has become the new standard in radiotherapy for prostate cancer (PCa) patients after being established as safe and non-inferior in randomized trials. Data from daily practice using these schedules are however scarce. We evaluated urinary and bowel dysfunction (health-related quality of life scores-HRQoL) after introduction of a hypofractionation (HF) and ultra-hypofractionation (UHF) schedule in our clinic. Materials and Methods T1b-T4 N0M0 localized PCa patients receiving 60 Gy in 20 fractions (HF20X3) or 42.7 Gy in 7 fractions (UHF 7X6.1) were recruited for our prospective cohort study between 2019-2022. Patients filled out (online invitation through email) the validated EPIC urinary and bowel modules (baseline, 6-months, yearly). Scores (Liker scale) are transformed to a 0-100% score with higher score indicating better functioning / HRQoL. Changes from baseline were calculated and considered clinically relevant at >10%. Results A total of N=197 filled out baseline + ≥ 1 questionnaire (N=97 HF20X3, N=90 HF7X6.1), maximum follow-up was 2 years. Average age was 73.7 years for HF20X3 vs 72.9 years for UHF7X6.1 (p=0.14). Patients with a low function at baseline (<70%) were excluded for related endpoints (N=8 bowel, N=13 urinary). For bowel function, both HF groups showed similar baseline values (95%). A drop >10% in bowel functioning was observed for 17%, 33%, 19% (HF20X3) vs 23%, 32%, 17% (UHF7X6.1) at 6, 12, and 24 months, respectively (all p NS). Looking at individual items, HF7X6.1 patients reported more often rectal blood loss at 6 months (17% vs 3%, p<0.01). Fecal incontinence at 12 months was more often reported in the HF20X3 group (26% vs 10%, p=0.03). For urinary function, baseline function score was 93.4% (HF20X3) vs 95.5% (UHF7X6.1) (p=0.054). A drop >10% was observed for 29%, 26%, 17% (HF20X3) vs 22%, 24%, 7% (UHF7X6.1) at 6, 12, and 24 months, respectively (all p NS). With respect to individual items, we observed that HF20X3 patients more frequently reported “dripping or leaking urine” at 6 months (37% vs 21% for UHF7X6.1, p=0.02) in the patient subgroup without such complaints at baseline. Conclusion Health-related QoL was similar between the evaluated HF schedules. Proportions of patients with a clinically relevant drop in bowel and urinary HRQL was comparable with previously published data from the HYPRO randomized trial (19x3.4 Gy s vs 39x2 Gy). The pattern of reported symptoms differed between HF20X3 and UHF7X6.1 and will be the subject of further study in this ongoing prospective cohort. 1 University Hospital LMU , Radiation Oncology, munchen, Germany; 2 University Hospital LMU , Radiation Oncology, Munich, Germany Purpose or Objective To evaluate the quality of life in patients with localized prostate cancer treated with a definitive hypofractionated radiotherapy (RT) using EORTC QLQ-C30 and -PR25 questionnaires. Materials and Methods In this prospective study, 143 patients with localized prostate cancer were included from Sep. 2019 to Oct. 2022. Most patients (138) were treated with hypofractionated RT of prostate (20 x 3 Gy) and five with ultra-hypofractionated RT (5 x 7.25 Gy, 3 fractions per week). Each patient was asked to fulfill EORTC QLQ-C30 and -PR25 questionnaires before RT, at RT end, 3 months, 1 year and 2 year after RT, respectively. Diverse functional scores (100 for the best and 0 for the worst function) and symptom scores (100 for the strongest and 0 for no symptoms) were calculated at each time point. Results In general, QLQ-C30 functional scores before RT were satisfactory and symptom scores were sparse. QLQ-PR25 symptom scores before RT were also sparse except urinary symptoms. The sexual functional scores were modest, probably due to the old age (median 75). At RT end, there was a slight decline of all the functional scores and a remarkable increase of symptom scores in terms of incontinence aid, diarrhoea, bowel symptoms, pain and loss of appetite. The increase of other symptom scores was moderate except financial difficulties, which even presented a decrease. Three months after RT, some functional scores (general healthy status, physical function, role and social function) almost recovered to their baseline level and sexual activity recovered only partially, while emotional function increase over its baseline and sexual function went even worse. Most symptoms clearly relieved, while nausea/vomiting, dyspnea and financial difficulties only partially relieved. Interestingly, constipation improved over baseline. As expected, hormonal treatment-related symptoms went worse due to the further use of anti-hormone therapy. One year after RT, most functional and symptom scores remained stable compared to the previous time point. However, constipation, insomnia, emotional, role and social function turn to the better over baseline while dyspnea, incontinence aid and sexual activity further went worse. Two year after RT, almost all the functional and symptom scores remained stable compared to the one year time point except diarrhoea, which went a little worse. PO-1539 Quality of life in prostate cancer patients treated with definitive hypofractionated radiotherapy J. Ma 1 , C. Trapp 2 , P. Rogowski 2 , N. Schmidt-Hegemann 1 , C. Belka 1 , M. Li 1

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