| Autor: |
Cuccia F; Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy., D'Alessandro S; Radiation Oncology School, University of Palermo, 90133 Palermo, Italy., Carruba G; Division of Internationalization and Health Research (SIRS), ARNAS Civico Hospital, 90100 Palermo, Italy., Figlia V; Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy., Spera A; Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy., Cespuglio D; Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy., Mortellaro G; Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy., Iacoviello G; Medical Physics, ARNAS Civico Hospital, 90100 Palermo, Italy., Lo Casto A; Radiation Oncology School, University of Palermo, 90133 Palermo, Italy., Tringali G; Neurosurgery Unit, ARNAS Civico Hospital, 90100 Palermo, Italy., Craparo G; Neuroradiology Unit, ARNAS Civico Hospital, 90100 Palermo, Italy., Blasi L; Medical Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy., Ferrera G; Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy. |
| Abstrakt: |
Background: The present study reports on the outcomes of our mono-institutional experience of Helical Tomotherapy (HT)-based SRT for brain metastases. The use of this linac is less frequently reported for this kind of treatment. Methods: This retrospective study displays a series of patients treated with HT-SRT. The eligibility of using SRT for brain metastases was defined by a Karnofsky performance status of >70, a life expectancy of >6 months, and controlled extra-cranial disease; no SRT was allowed in the case of a number of brain metastases larger than 10. All the cases were discussed by a multidisciplinary board. Toxicity assessments were performed based on CTCAE v5.0. Survival endpoints were assessed using the Kaplan-Meier method, and univariate and multivariate analyses were carried out to identify any potential predictive factor for an improved outcome. Results: Sixty-four lesions in 37 patients were treated using HT-SRT with a median total dose of 30 Gy in five fractions. The median follow-up was 7 months, and the 1- and 2-year LC rates were both 92.5%. The IPFS rates were and 56.75% and 51.35%. The OS rates were 54% and 40%. The UA showed better IPFS rates significantly related to male sex ( p = 0.049), a BED 12 of ≥42 Gy ( p = 0.006), and controlled extracranial disease ( p = 0.03); in the MA, a favorable trend towards LC ( p = 0.11) and higher BED ( p = 0.11) schedules maintained a correlation with improved IPFS rates, although statistical significance was not reached. Conclusions: HT-based SRT for brain metastases showed safety and efficacy in our monoinstiutional experience. Higher RT doses showed statistical significance for improved outcomes of LC and OS. |
