ESTRO 2022 - Abstract Book

S1213

Abstract book

ESTRO 2022

PO-1430 A Retrospective study of outcomes with stereotactic radiosurgery for melanoma brain metastasis.

M. Burke 1 , G. Rangaswamy 2 , M. Dunne 3 , J. Armstrong 4 , C. Faul 5 , D. Fitzpatrick 1

1 St Lukes Radiation Oncology Network, Radiation Oncology, Dublin, Ireland; 2 St Lukes Radiation Oncology Network , Radiation oncology, Dublin, Ireland; 3 St Lukes Radiation Oncology Network , Medical Statistics , Dublin , Ireland; 4 St Lukes Radiation Oncology Network , Radiation Oncology, Dublin, Ireland; 5 St Lukes Radiation Oncology Network , Radiation Oncology, Dublin , Ireland Purpose or Objective Malignant Melanoma is the third most common cause of brain metastases behind lung and breast cancer. Between 10% and 40% of patients are diagnosed with brain metastases during the course of their disease. The median survival in these patients is 4–5 months, with intracranial disease progression being the direct cause of death in 20%–54%. The median overall survival (OS) ranged between 8–10 months even in patients who received local treatments. The main treatment modalities are surgery, whole-brain radiotherapy (WBRT) and stereotactic radiotherapy (SRS). WBRT is associated with increased neurotoxicity and decreased quality of life. Stereotactic radiosurgery (SRS) is an increasingly used treatment with good effect. There is additional benefit gained when combined with immune checkpoint inhibitors. We present a retrospective review of patients with malignant melanoma metastasis to brain treated at our institution with SRS. Materials and Methods Patients who received SRS for malignant melanoma metastasis between August 2013 and November 2016 were identified. We obtained patient data including age, gender, toxicities and tumour characteristics including BRAF status. Image fusion and treatment planning were done on iPlan radiotherapy planning software. Follow-up imaging was reviewed to document treatment response. OS was calculated from the day SRS was completed to the date of last follow-up or death. The Kaplan- Meier method was used to estimate survival times for individual patients. Results Twenty-nine patients were identified, fifteen female and fourteen male. The median age was 54 years. Six Patients had prior WBRT. Sixty-one metastasis were treated, with fifty-one treated in a single fraction, four treated with three fractions and six treated with five fractions. Eleven patients had BRAF mutation, twelve were wild type and six were unknown. Ten patients received concurrent systemic treatment. The median single fraction dose used was 20 Gray (range 16 – 24 Gy). The most common toxicity documented was effect on memory, hair loss and fatigue. The median OS was 8.1 months (95% CI: 0.4 – 15.8 months). Eight patients (28%) died within 3 months of their treatment. Three patients (10%) were alive more than 4 years post completion of SRS. The OS in BRAF mutated patients was 11.5 months (95% CI: 3 – 20 months). In those who received concurrent systemic treatment the OS was 23.8 months (95% CI: 0 – 69.7 months) compared to 4.4 months (95% CI: 0 - 12.7 months) in those who did not receive concurrent systemic treatment. Conclusion Stereotactic radiosurgery for brain metastases from Melanoma has been shown to prolong OS when compared to WBRT when used a stand-alone treatment modality or in combination with immunotherapy. Whilst our retrospective analysis has showed that SRS is an effective treatment option and results in comparable OS rates as per reported literature, further multicentre randomized control trials are required to further evaluate the effectiveness of SRS in this patient cohort. 1 Campus Bio-Medico University of Rome, Radiation Oncology, Rome, Italy; 2 Campus Bio-Medico University of Rome , Radiation Oncology, Rome, Italy; 3 Campus Bio-Medico University of Rome , Department of Surgery, Rome, Italy; 4 Campus Bio-Medico University of Rome, Medical Oncology Department, Rome, Italy Purpose or Objective The purpose of the study is to analyze the response rate (RR) and the side effects of the combined treatment including hyperthermia, radiotherapy and chemotherapy for patients with soft tissue sarcomas (STS). Materials and Methods We retrospectively reviewed patients affected by STS treated at our institution with hyperthermia combined with radiotherapy and/or chemotherapy. Two radiative hyperthermia (HT) devices were used: BSD-500 system for superficial HT and BSD-2000 system for deep regional HT for target sited >4 cm from the skin. Duration of each HT session was of 60 minutes with target temperature >40°. The dose for neoadjuvant or adjuvant treatments was 45-50 Gy and 60-66 in case of radical intent, with conventional fractionation. Chemotherapy consisted of gemcitabine 300 mg/mq administered weekly during radiotherapy or HD-ifosfamide i.c. The RR was evaluated by CT scan and MRI scan. The assessment of adverse events was reported according to NCI CTCAE v4.0. Results From November 2019 to May 2021 twenty-one patients (8 males and 13 females, median age 65.5 years) with STS were treated with the combination. Eighteen patients had localized disease and 3 had metastastic disease. The most frequent sites of treatment were the lower limb and the abdominal-pelvic region. The mean target size was 7.9 cm (range 1-20 cm). PO-1431 Integrated therapies for soft tissue sarcomas: a single institution experience from Italy using hyperthermia in association with radiotherapy and chemotherapy. P. trecca 1 , M. Fiore 1 , G. D'Ercole 1 , G.M. Petrianni 1 , C. Greco 2 , E. Ippolito 1 , L. Marinelli 1 , S. Valeri 3 , B. Vincenzi 4 , S. Ramella 1