Impact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastases

BMC Cancer

Morgan Guénolé¹  Emmanuelle Reygagne¹  Gaëlle Goasduff¹  Ulrike Schick²  Vincent Bourbonne²  Gurvan Dissaux²  Olivier Pradier²  François Lucia² 

[1] Radiation Oncology Department, University Hospital Morvan, 2 Avenue Foch, F-29200, Brest, France;Radiation Oncology Department, University Hospital Morvan, 2 Avenue Foch, F-29200, Brest, France;Latim INSERM UMR 1101, UBO, Brest, France;

关键词: Stereotactic radiotherapy;    Brain metastases;    Systemic therapies;    Immunotherapy;    Radioimmunotherapy;   

DOI  :  10.1186/s12885-020-07491-z

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to determine the safety and efficacy of fractionated stereotactic radiotherapy (SRT) in combination with systemic therapies (ST) for brain metastases (BM).MethodsNinety-nine patients (171 BM) received SRT and concurrent ST (group 1) and 95 patients (131 BM) received SRT alone without concurrent ST (group 2). SRT was planned on a linear accelerator, using volumetric modulated arc therapy. All ST were allowed including chemotherapy (CT), immunotherapy (IT), targeted therapy (TT) and hormonotherapy (HT). Treatment was considered to be concurrent if the timing between the drug administration and SRT did not exceed 1 month. Local control (LC), freedom for distant brain metastases (FFDBM), overall survival (OS) and radionecrosis (RN) were evaluated.ResultsAfter a median follow-up of 11.9 months (range 0.7–29.7), there was no significant difference between the two groups. However, patients who received concurrent IT (n = 30) had better 1-year LC, OS, FFDBM but a higher RN rate compared to patients who did not: 96% versus 78% (p = 0.02), 89% versus 77% (p = 0.02), 76% versus 53% (p = 0.004) and 80% versus 90% (p = 0.03), respectively. In multivariate analysis, concurrent IT (p = 0.022) and tumor volume < 2.07 cc (p = 0.039) were significantly correlated with improvement of LC. The addition of IT to SRT compared to SRT alone was associated with an increased risk of RN (p = 0.03).ConclusionSRT delivered concurrently with IT seems to be associated with improved LC, FFDBM and OS as well as with a higher rate of RN.

【 授权许可】

CC BY