ESTRO 2024 - Abstract Book

S1957

Clinical - Mixed sites, palliation

ESTRO 2024

Olaf Wittenstein 1 , Frank-Andre Siebert 1 , Hendrik Bonnemeier 2 , Jürgen Dunst 1 , Evgeny Lyan 2 , Roland R Tilz 10 , Oliver Blanck 1 1 Universitätsklinikum Schleswig-Holstein, Klinik für Strahlentherapie, Kiel, Germany. 2 Universitätsklinikum Schleswig Holstein, Klinik für Innere Medizin III, Kardiologie, Abteilung für Elektrophysiologie und Rhythmologie, Kiel, Germany. 3 Universitätsmedizin Mannheim, Universität Heidelberg Medizinische Fakultät Mannheim, Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany. 4 Universitätsmedizin Mannheim, Universität Heidelberg Medizinische Fakultät Mannheim, Medizinische Klinik I, Abteilung für Elektrophysiologie und Rhythmologie, Mannheim, Germany. 5 Charité Universitätsmedizin Berlin, Klinik für Radioonkologie und Strahlentherapie, Berlin, Germany. 6 Charité Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Kardiologie (CVK), Campus Virchow Klinikum, Berlin, Germany. 7 Medizinische Hochschule Hannover, Hannover Herzrhythmus Centrum, Klinik für Kardiologie und Angiologie, Hannover, Germany. 8 Medizinische Hochschule Hannover, Klinik für Strahlentherapie, Hannover, Germany. 9 Universitätsklinikum Schleswig-Holstein, Klinik für Strahlentherapie, Lübeck, Germany. 10 Universitätsklinikum Schleswig-Holstein, Klinik für Rhythmologie, Lübeck, Germany. 11 Klinikum der Ludwig-Maximilians-Universität München, Klinik für Strahlentherapie und Radioonkologie, München, Germany. 12 Klinikum der Ludwig-Maximilians-Universität München, Medizinische Klinik und Poliklinik I, München, Germany

Purpose/Objective:

Stereotactic Arrhythmia Radioablation (STAR) has been shown to be a promising treatment option for refractory ventricular tachycardia (VT) in initial reports of monocentric clinical studies and case series [1,2]. Further data from prospective clinical multicenter multiplatform trials are eagerly awaited.

Material/Methods:

The multicenter RAdiosurgery for VENtricular TAchycardia (RAVENTA) study (NCT03867747) is part of the STOPSTORM.eu consortium project (EU-Horizon-2020 Grand No. 945119) [3,4]. In patients with refractory VT, high precision image-guided single-session stereotactic body radiotherapy (SBRT) with 25 Gy was delivered to the VT substrate determined by high-definition endocardial electrophysiological mapping and/or scar imaging. The primary endpoint was safety in terms of successful dose delivery without severe treatment-related side effects in the first 30 days after treatment.

Results:

Twenty patients (17 male, 3 female) were included in the RAVENTA study at six university medical centers between 11/2019 and 10/2023. The median patient age was 64 years (49-84 years). The underlying structural heart disorder was ischemic cardiomyopathy in 9 patients and non-ischemic cardiomyopathy in 11 patients. Patients had undergone a median of 2.5 (0-8) prior catheter ablations. As motion management strategy for SBRT either an internal target volume (15/20) or gating (5/20) approach was performed. The used radiation techniques were Intensity Modulated Arc Therapy (16/20), Dynamic Conformal Arc (2/20), Robotic Guided (1/20) and Step and Shoot Intensity Modulated Radiotherapy (1/20). The median clinical target volume and planning target volume were 16.5 cc (6.0-87.8 cc) and 74.8 cc (31.7-144.3 cc), respectively. PTV D50%, D98% and D2% were 27.9 Gy (26.1-29.1 Gy), 24.6 Gy (19.3-25.4 Gy) and 29.7 Gy (27.3-31.6 Gy), respectively. Median treatment time was 16 minutes (4-100 minutes).