Filippo Alongi1,2, Alba Fiorentino1, Fabiana Gregucci3, Stefanie Corradini4, Niccolo Giaj-Levra1, Luigi Romano5, Michele Rigo1, Francesco Ricchetti1, Alberto Beltramello5, Gianluigi Lunardi6, Rosario Mazzola1, Ruggero Ruggieri1. 1. Department of Radiation Oncology, IRCCS, Ospedale Sacro Cuore Don Calabria, Via don A. Sempreboni 5, 37024, Negrar, Verona, Italy. 2. University of Brescia, Piazza del Mercato 15, 25121, Brescia, Italy. 3. Department of Radiation Oncology, IRCCS, Ospedale Sacro Cuore Don Calabria, Via don A. Sempreboni 5, 37024, Negrar, Verona, Italy. fabianagregucci@gmail.com. 4. Department of Radiation Oncology, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany. 5. Department of Radiology, IRCCS, Ospedale Sacro Cuore Don Calabria, Via don A. Sempreboni 5, 37024, Negrar, Verona, Italy. 6. Department of Medical Oncology, IRCCS, Ospedale Sacro Cuore Don Calabria, Via don A. Sempreboni 5, 37024, Negrar, Verona, Italy.
Abstract
INTRODUCTION: Radiosurgery (SRS) or stereotactic fractionated radiotherapy (SFRT) is increasing in the treatment of brain metastases (BMs). Aim of the present study was to evaluate the safety and effectiveness of SRS/SFRT for BMs, using a new mono-isocenter non-coplanar solution (HyperArc™ Varian Medical System). METHODS: BMs patients with a diameter inferior to 3 cm, a life expectancy of more than 3 months and a good performance status, were eligible for Linac-based volumetric modulated arc therapy (VMAT) SFRT/SRS with HyperArc™. A retrospective analysis of patients and BMs was performed. RESULTS: From August 2017 to May 2018, 381 BMs in 64 patients were treated and 246 BMs (43 patients, median number of BMs: 5) of them were suitable for analysis. With a median FU time of 6 months, 244 out 246 (99%) BMs were controlled (18% complete response; 41% partial response, 40% stable disease), 2 BMs showed a progression, at the first control. No acute or late toxicities were reported. Median overall survival (OS) has not yet been achieved, while median time to progression was 5 months. In univariate analysis, statistically negative prognostic factors for OS were histology of primary tumor (p = 0.009): lung/breast cancer had better survival rates as compared to others. Cumulative intracranial volume disease ≥ 15 cc and systemic progression disease were independent prognostic factors for OS at univariate (p = 0.04; p = 0.005) and multivariate (p = 0.04; p = 0.009) analysis, respectively. CONCLUSION: The present first clinical data show that SFRT/SRS with HyperArc™ is safe and effective for BMs patients. The utilization of SFRT/SRS for BMs is promising and should be further explored in randomized trials.
INTRODUCTION: Radiosurgery (SRS) or stereotactic fractionated radiotherapy (SFRT) is increasing in the treatment of brain metastases (BMs). Aim of the present study was to evaluate the safety and effectiveness of SRS/SFRT for BMs, using a new mono-isocenter non-coplanar solution (HyperArc™ Varian Medical System). METHODS: BMs patients with a diameter inferior to 3 cm, a life expectancy of more than 3 months and a good performance status, were eligible for Linac-based volumetric modulated arc therapy (VMAT) SFRT/SRS with HyperArc™. A retrospective analysis of patients and BMs was performed. RESULTS: From August 2017 to May 2018, 381 BMs in 64 patients were treated and 246 BMs (43 patients, median number of BMs: 5) of them were suitable for analysis. With a median FU time of 6 months, 244 out 246 (99%) BMs were controlled (18% complete response; 41% partial response, 40% stable disease), 2 BMs showed a progression, at the first control. No acute or late toxicities were reported. Median overall survival (OS) has not yet been achieved, while median time to progression was 5 months. In univariate analysis, statistically negative prognostic factors for OS were histology of primary tumor (p = 0.009): lung/breast cancer had better survival rates as compared to others. Cumulative intracranial volume disease ≥ 15 cc and systemic progression disease were independent prognostic factors for OS at univariate (p = 0.04; p = 0.005) and multivariate (p = 0.04; p = 0.009) analysis, respectively. CONCLUSION: The present first clinical data show that SFRT/SRS with HyperArc™ is safe and effective for BMs patients. The utilization of SFRT/SRS for BMs is promising and should be further explored in randomized trials.
Authors: F Alongi; L Nicosia; V Figlia; N Giaj-Levra; F Cuccia; R Mazzola; F Ricchetti; M Rigo; C Vitale; A De Simone; S Naccarato; G Sicignano; D Gurrera; S Corradini; R Ruggeri Journal: Clin Transl Oncol Date: 2021-02-11 Impact factor: 3.405
Authors: Edward T Cullom; Yuqing Xia; Kai-Cheng Chuang; Zachary W Gude; Yana Zlateva; Justus D Adamson; William M Giles Journal: J Appl Clin Med Phys Date: 2021-06-24 Impact factor: 2.102
Authors: Jill S Remick; Emily Kowalski; Rahul Khairnar; Kai Sun; Emily Morse; Hua-Ren R Cherng; Yannick Poirier; Narottam Lamichhane; Stewart J Becker; Shifeng Chen; Akshar N Patel; Young Kwok; Elizabeth Nichols; Pranshu Mohindra; Graeme F Woodworth; William F Regine; Mark V Mishra Journal: Radiat Oncol Date: 2020-05-28 Impact factor: 3.481
Authors: P Freislederer; M Kügele; M Öllers; A Swinnen; T-O Sauer; C Bert; D Giantsoudi; S Corradini; V Batista Journal: Radiat Oncol Date: 2020-07-31 Impact factor: 3.481