(P009) Fractionated Stereotactic Radiation in the Management of Previously Irradiated Brain Metastases

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OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

In this series, we note good local control with an adequate toxicity profile for brain metastases reirradiated with fractionated stereotactic radiation therapy.

Jeffrey Peacock, BS, Kamran Ahmed, MD, Peter Johnstone, MD, Siriporn Sarangkasiri, MS, Arnold Etame, MD, PhD, Michael Yu, MD; University of Central Florida College of Medicine; H. Lee Moffitt Cancer Center

BACKGROUND: Failure of brain metastases to respond following prior radiation therapy (RT) can raise challenges for practitioners. The purpose of this study was to determine outcomes and toxicities associated with reirradiation with fractionated stereotactic radiation therapy (FSRT) of recurrent brain metastases.

METHODS: Thirty-one consecutive lesions in 22 patients were treated with FSRT between January 2010 and December 2014 following prior RT. Patients were treated in five fractions, and doses were prescribed to cover at least 95% of the planning target volume (PTV). The primary endpoint for this study was local failure. Twenty-four lesions (77.4%) received prior whole-brain radiation therapy (WBRT), and seven lesions (22.6%) were treated with stereotactic radiosurgery (SRS) at the site prior to FSRT. The median time between reirradiation with FSRT was 11.5 months (range: 1–97.3 mo).

RESULTS: The 1-year local control rate was 74.3%, and distant control was achieved in six patients (27.3%). The 1-year survival rate was 46.9% and was associated with recursive partitioning analysis (RPA) class designation (P = .044). Four patients (18%)-all of whom received WBRT prior to FSRT-experienced treatment-related side effects; these were managed with steroids, with one lesion found to undergo pathologically confirmed radionecrosis. No toxicities were noted in patients treated with SRS prior to FSRT.

CONCLUSION: In this series, we note good local control with an adequate toxicity profile for brain metastases reirradiated with FSRT.

Proceedings of the 98th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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