Radionecrosis (RN) in patients with brain metastases treated with stereotactic radiosurgery (SRS) and immunotherapy
| Autor: | Lauren Andring, Inga S. Grills, Zachary A. Seymour, Jeffrey Jacob, K. Marvin, Bryan S. Squires, Daniel K. Fahim, Hong Ye |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Univariate analysis Multivariate analysis business.industry General Neuroscience medicine.medical_treatment General Medicine Immunotherapy Radiosurgery Conformity index Lesion 03 medical and health sciences 030104 developmental biology 0302 clinical medicine medicine Overall survival In patient medicine.symptom business Nuclear medicine 030217 neurology & neurosurgery |
| Zdroj: | The International journal of neuroscience. |
| ISSN: | 1563-5279 |
| Popis: | OBJECTIVES Limited data exist regarding radionecrosis (RN) rates when patients receive immunotherapy (IT) and SRS for brain metastases. This study assesses the influence of such treatments on the rate of RN. METHODS We retrospectively reviewed 352 lesions from 105 patients with metastatic melanoma or NSCLC treated with SRS and IT from 2012 to 2018. Lesions were excluded from analysis if patients had received WBRT or prior GK to the same lesion, if RN occurred before IT, or if IT had been discontinued >6 months pre-SRS or initiated >1 year post-SRS. IT was delivered concurrently (±30 days of SRS) or sequentially. Overall survival and RN rates were assessed with Kaplan-Meier analysis. Univariate analysis and multivariate analysis were performed to identify characteristics predicting RN. RESULTS Of 195 lesions from 63 patients included in analysis, the median prescription dose, IDL, lesion volume, and maximum tumor dimension (MTD) were 19 Gy, 50%, 0.15 cc and 0.8 cm, respectively. RN rates at 1, 2, and 3 years were 7.3%, 10.4% and 10.4%. On UVA, RN risk increased with, isodose volume (IDV), MTD, and tumor volume (TV) whereas conformity index was associated with a trend toward decreased RN risk. Two-year RN rates increased with TV ≥ 0.3 cc (16% vs 1.1% p = 0.001), MTD ≥ 1.3 cm (19.1% vs 1.8% p |
| Databáze: | OpenAIRE |
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