SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES

Fia Cialdella,An Claes,Karin Kleynen,Marielle Philippens,Arthur Van Der Boog,Martine Van Zandvoort,Steven Nagtegaal,Enrica Seravalli,Ernst Smid,Joost Verhoeff,Eva Van Grinsven

doi:10.1093/noajnl/vdad070.106

Fia Cialdella, An Claes + Show 9 more

Open Access

https://doi.org/10.1093/noajnl/vdad070.106

Copy DOI

Abstract

Abstract INTRODUCTION Brain metastases (BMs) occur in 10-30% of adult patients with cancer. The therapeutic approach for BMs depends on several factors including lesion number, location and size, primary cancer type, and the patient’s overall health. ASCO-SNO-ASTRO guidelines conditionally recommend stereotactic radiosurgery (SRS) for 1-10 BMs. The aim of this study was to investigate the outcomes of radiotherapy in patients with 5 or more BMs using SRS. METHODS We implemented the prospective Cohort for patient-reported Outcomes, Imaging and trial inclusion in Metastatic BRAin disease (COIMBRA) to examine all patients with BM(s) who underwent radiotherapy. In this sub-study we investigated overall survival (OS) and health related quality of life (HRQoL) for 47 patients with 5 to 20 BMs. We evaluated patients’ HRQoL using the EQ5D-VAS, at baseline and at 3 monthly intervals after radiotherapy. RESULTS Median OS was 21.3 months for patients with 5-10 BMs (n=38) and 12.5 months for patients with &gt;10 BMs (n=9). Questionnaires at both baseline and 6 months after radiotherapy showed stability or improvement on the EQ5D-VAS after radiotherapy in 58.1%. Additionally, independence in self-care was not limited before or after SRS. Also, the proportion of patients (66.7%) reporting no limitation on their ability to do daily activities remained stable after radiotherapy. Fewer patients reported pain or other discomfort after SRS compared to before (25% vs 40%). CONCLUSION Our findings suggest that radiotherapy may improve QoL in patients with 5-20 BMs. Furthermore, compared to the literature, we observed a prolonged OS in this prospective cohort, suggesting that SRS should be considered as the treatment option for these patients. These results highlight the need for further investigation of the role of SRS instead of Whole Brain Radiotherapy (WBRT) in the management of patients with multiple BMs.

Full Text