2017_SBRT_Course Book

Oligo-progression: SBRT & switch to next line systemic Tx

Prospective Phase II trial: 24 patients with 52 sites • Maximum 5 Platin-resistant sites based on FDG-PET

• SBRT to all progressive sites, • Switch to concurrent Erlotinib

Iyenger JCO 2014

PFS median 15 mo

In-field failure

3 / 21

Out-field failure

10 / 21

No failure

10 / 21

Ø Highly favorable failure pattern Ø Promising OS (in highly selected patients)

07.09.17 ESTRO SBRT COURSE 2017 - Matthias Guckenberger

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Brain mets in patients with driver mutations

Cancer with available effective systemic Tx e.g. activating driver mutation Development of brain metastases

Small asymptomatic

Large symptomatic

Systemic treatment

Local treatment

Ø Safe concept to delay local RT / SRS ?

07.09.17 ESTRO SBRT COURSE 2017 - Matthias Guckenberger

16

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