ESTRO 2024 - Abstract Book

S2068

Clinical - Paediatric

ESTRO 2024

A total of 106 cases with extracranial oligometastases and concurrently detected brain metastases were identified, mostly from skin (melanoma, squamous cell) or lung/pleura (NSCLC, SCLC, mesothelioma) cancers (91%, n=96). The diagnosis of brain metastases resulted in a transition from an extracranial oligometastatic to a polymetastatic state in 45% (n=48/n=106) of cases. After the OMD imaging diagnosis, systemic therapy was more commonly prescribed in oligo- versus polymetastatic patients (55% vs. 35%), and stereotactic irradiation for treatment of brain metastases was more commonly employed in polymetastatic patients (44% vs. 26%). While there was a trend towards differences in the therapeutic approach towards intracranial disease, the differences between both sub-groups were not statistically significant. The OMD state was, however, associated with significantly longer overall survival: Oligometastatic cancer patients had a median overall survival of 28 months compared to 10 months in polymetastatic patients (p<0.01) (Figure 1).

Conclusion:

In this cohort of oligometastatic cancer patients with maximum five extracranial metastases and subsequent detection of brain metastases, a low tumor burden considering extra-cranial and intra-cranial metastases for definition of an OMD state remained a significant prognostic factor for overall survival. Our results suggest that the presence of brain metastases should neither be an exclusion criterion for the conceptualization of future clinical trials in the field of OMD nor for considering a multimodality treatment strategy in oligometastatic cancer patients.

Keywords: Oligometastasis, brain metastasis

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