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Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.059
vdae090.059
Final Category: Multimodality Approaches
AcademicSubjects/MED00300
AcademicSubjects/MED00310
MMOD-15 SURGICAL RESECTION AND STEREOTACTIC RADIOSURGERY IN COMBINATION FOR LOCAL THERAPY OF BRAIN METASTASES
Fadrus Pavel Department of Neurosurgery, University Hospital Brno, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Vybihal Vaclav Department of Neurosurgery, University Hospital Brno, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Juran Vilem Department of Neurosurgery, University Hospital Brno, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Pukova Andrea Sprlakova Department of Radiology and Nuclear Medicine,University Hospital Brno, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Kerkovsky Milos Department of Radiology and Nuclear Medicine,University Hospital Brno, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Kren Leos Department of Pathology, University Hospital Brno, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Lakomy Radek Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Kazda Tomas Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Hynkova Ludmila Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Vecera Marek Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Hermanova Marketa First Department of Pathology, St. Anne’s University Hospital Brno, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Jancalek Radim Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Sana Jiri Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Slaby Ondrej Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Slampa Pavel Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

Smrcka Martin Department of Neurosurgery, University Hospital Brno, Brno, Czech Republic
Faculty of Medicine, Masaryk University, Brno, Czech Republic

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i19i19
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

OBJECTIVES

Complex local treatment of BM combining surgical resection and radiosurgery provides the possibility of adequate local control while maintaining a satisfactory quality of life.

METHODS

Patients after surgical resection and postoperative radiotherapy treated between 2007-2023 were evaluated. Local control was assessed separately at the site of the operated MM (localPFS) and separately in other parts of the brain (distalPFS).

RESULTS

A total of 158 patients were enrolled (70 with WBRT), 56% were women, the median age was 61 years, the median performance status Karnofsky 78%. The most common primary tumor was lung carcinoma (39/118, 33%). Targeted stereotactic radiotherapy was significantly more often indicated in operations performed after 2016 (p <0.001). In the period 2013-2019, gross total resection was achieved significantly more often (88 vs 64%; p = 0.061). The median follow-up is 51 months. The median overall survival (OS) is 9,5 months (6.2 - 12), the median localPFS 24 months (14 - unattainable), median distPFS 12 months (6.8 - 27 months), median extracranialPFS 13 months (5.9 - 15). Stratification of patients according to the prognostic index brainmetgpa.com led to significant separation of patients for OS (p = 0.00017). In a multivariate analysis, stereotactic radiotherapy was statistically significant positive prognostic factor for OS compared to WBRT (median OS 18 vs. 6,1 months, HR 0.59, p = 0.018) with no effect on localPFS.

CONCLUSION

Our results of comprehensive local treatment of BM are comparable with the results presented by important foreign studies from prestigious oncology centers. We described targeted stereotactic postoperative radiotherapy as an independent positive prognostic factor after brain metastasectomy. The study was supported by Ministry of Health, Czech Republic-conceptual development of research organization (FNBr, 65269705).
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