ESTRO 2024 - Abstract Book

S811

Clinical - CNS

ESTRO 2024

Palliative whole brain radiation therapy: an international state of practice

Melissa Woodward 1 , Emily Keit 2 , Shing Fung Lee 3,4 , Kevin Shiue 5 , Isacco Desideri 6 , Eva Oldenburger 7 , Maya Bienz 8 , Dirk Rades 9 , Marilena Theodorou 10 , Mervin B Agyeman 11 , Joel Yarney 11,12 , John M Bryant 2 , Hsiang-Hsuan Michael Yu 2 , Charles B Simone II 13 , Peter Hoskin 14,8 , Peter A.S. Johnstone 2 , Agata Rembielak 15,14 1 The Christie at Oldham, The Christie NHS Foundation Trust, Department of Radiotherapy, Manchester, United Kingdom. 2 H.Lee Moffitt Cancer Centre and Research Institute, Department of Radiation Ocology, Tampa, Florida, USA. 3 National University cancer Institute, National University Hospital, Department of Radiation Oncology, Singapore, Singapore. 4 Tuen Mun Hospital, New Territories West cluster, Hospital Authority, Department of Clinical Oncology, Hong Kong, China. 5 Indiana University School of Medicine, Department of Radiation Ocology, Indianapolis, USA. 6 University of Florence, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", Florence, Italy. 7 University Hospitals Leuven, Department of Radiation Ocology, Leuven, Belgium. 8 Mount Vernon Cancer Centre, -, Northwood, United Kingdom. 9 University Medical Centre Schleswig-Holstein, Campus Lübeck, Department of Radiation Ocology, Lübeck, Germany. 10 Bank of Cyprus Oncology Center, -, Nicosia, Cyprus. 11 National Centre for Radiotherapy and Nuclear medicine, -, Accra, Ghana. 12 University of Cape Coast, -, Cape Coast, Ghana. 13 New York Proton Center, -, New York, USA. 14 The University of Manchester, Division of Cancer Sciences,School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester, United Kingdom. 15 The Christie NHS Foundation trust, Department of Clinical Oncology, Manchester, United Kingdom

Purpose/Objective:

To undertake a global review of the use of whole brain radiotherapy (WBRT) for the palliation of brain metastases and explore the appropriateness of this treatment choice in the advent of stereotactic radiotherapy and improved systemic therapies.

Material/Methods:

A multi-centre, international retrospective analysis of patients receiving WBRT in 2022 was performed. Patients receiving WBRT as part of curative treatment, prophylactically, as bridging therapy or under the age of 18 were excluded. The primary end point was survival following WBRT completion. The collected data consisted of patient parameters including prescription does and fractionation, use of neurocognitive sparing techniques, prior stereotactic radiosurgery (SRS), primary tumour site and survival following WBRT. Survival was calculated via the Kaplan-Meier method. All data was anonymised and analysed centrally.

Results:

Patients were represented by 10 participating centres across four continents, North America, Europe, Asia and Africa. Of the 29,943 prescriptions written in these centres during 2022, 462 (1.5%) were for palliative WBRT. WBRT prescriptions accounted for 1-3% of total radiotherapy prescriptions from each institution. Globally, the most common primary cancers were Lung (41.8%) and breast (28.4%). Survival ranged from 0 days post-WBRT to still surviving at 402 days post-WBRT. The global median overall survival (OS) was 84 days after completion. Twenty seven patients (5.8%) were unable to complete their prescribed course of WBRT.