Radiation necrosis in renal cell carcinoma brain metastases treated with checkpoint inhibitors and radiosurgery: An international multicenter study

Autor: Eric J. Lehrer, Jason Gurewitz, Kenneth Bernstein, Dev Patel, Douglas Kondziolka, Ajay Niranjan, Zhishuo Wei, L. Dade Lunsford, Timothy D. Malouff, Henry Ruiz‐Garcia, Samir Patel, Phillip A. Bonney, Lindsay Hwang, Cheng Yu, Gabriel Zada, David Mathieu, Claire Trudel, Rahul N. Prasad, Joshua D. Palmer, Brianna M. Jones, Sonam Sharma, Kareem R. Fakhoury, Chad G. Rusthoven, Christopher P. Deibert, Piero Picozzi, Andrea Franzini, Luca Attuati, Cheng‐Chia Lee, Huai‐Che Yang, Manmeet S. Ahluwalia, Jason P. Sheehan, Daniel M. Trifiletti
Rok vydání: 2022
Předmět:
Zdroj: Cancer. 128:1429-1438
ISSN: 1097-0142
0008-543X
DOI: 10.1002/cncr.34087
Popis: Patients with renal cell carcinoma (RCC) brain metastases are frequently treated with immune checkpoint inhibitors (ICIs) and stereotactic radiosurgery (SRS). However, data reporting on the risk of developing radiation necrosis (RN) are limited.RN rates were compared for concurrent therapy (ICI/SRS administration within 4 weeks of one another) and nonconcurrent therapy with the χFifty patients (23 concurrent and 27 nonconcurrent) with 395 brain metastases were analyzed. The median follow-up was 12.1 months; the median age was 65 years. The median margin dose was 20 Gy, and 4% underwent prior whole-brain radiation therapy (WBRT). The median treated tumor volume was 3.32 cmSymptomatic RN occurs in a minority of patients with RCC brain metastases treated with ICI/SRS. The majority of events were grade 1 to 3 and were managed medically. Concurrent ICI/SRS does not appear to increase this risk. Attempts to improve dose conformality (reduce V12) may be the most successful mitigation strategy in single-fraction SRS.
Databáze: OpenAIRE
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