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

10.1093/noajnl/vdae090.062
vdae090.062
Final Category: Multimodality Approaches
AcademicSubjects/MED00300
AcademicSubjects/MED00310
MMOD-18 THE IMPACT OF CONTRAST CLEARANCE ANALYSIS-GUIDED REPEAT SRS ON SURVIVAL IN PATIENTS WITH BRAIN METASTASES
Madhugiri Venkatesh Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Goulenko Victor Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Recker Matthew Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Prasad Dheerendra Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Plunkett Robert Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i19i20
© 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

PURPOSE

Adverse radiation effects (ARE) including pseudoprogression are known toxicities associated with radiation for intracranial lesions. ARE are often difficult to differentiate from tumor progression. Delay in identification of tumor progression or misidentification of progression as ARE can lead impact patient survival. In this study, we demonstrate the utility of Contrast Clearance Analysis® (CCA) in differentiating ARE from progression and the impact of CCA-guided decision making on patient survival.

METHODS

Fifty-seven consecutive patients who had been diagnosed with brain metastasis and treated with Gamma Knife Radiosurgery (GKRS) and had presented with suspicious lesion growth on follow-up MRI scans underwent CCA to distinguish between treatment effect and tumor progression. Lesions considered to have recurrence were retreated with repeat GKRS. Survival analyses were carried out to evaluate the impact of early CCA-guided retreatment on survival.

RESULTS

The most common primary disease was non-small cell lung cancer (40%), followed by breast cancer (12%) and melanoma (11%). The use of CCA indicated ARE in 24 lesions and 35 to be pseudoprogression. The total follow-up period was of 72 months. Kaplan-Meir Survival Analyses showed that retreated patients had better survival than the general cohort of patients who did not have CCA-informed retreatments (p< 0.05).

CONCLUSION

CCA is a promising tool to distinguish between tumor progression and ARE in the setting of radiosurgical treatment. Early differentiation allows early retreatment and improvement of the patient survival.
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pmc
