Impact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastases
Abstract Background The aim of this study was to determine the safety and efficacy of fractionated stereotactic radiotherapy (SRT) in combination with systemic therapies (ST) for brain metastases (BM). Methods Ninety-nine patients (171 BM) received SRT and concurrent ST (group 1) and 95 patients (13...
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doaj-fc5c5bece3584e94b1473d0ab1efd7222020-11-25T03:54:04ZengBMCBMC Cancer1471-24072020-10-0120111110.1186/s12885-020-07491-zImpact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastasesMorgan Guénolé0François Lucia1Vincent Bourbonne2Gurvan Dissaux3Emmanuelle Reygagne4Gaëlle Goasduff5Olivier Pradier6Ulrike Schick7Radiation Oncology Department, University Hospital MorvanRadiation Oncology Department, University Hospital MorvanRadiation Oncology Department, University Hospital MorvanRadiation Oncology Department, University Hospital MorvanRadiation Oncology Department, University Hospital MorvanRadiation Oncology Department, University Hospital MorvanRadiation Oncology Department, University Hospital MorvanRadiation Oncology Department, University Hospital MorvanAbstract Background The aim of this study was to determine the safety and efficacy of fractionated stereotactic radiotherapy (SRT) in combination with systemic therapies (ST) for brain metastases (BM). Methods Ninety-nine patients (171 BM) received SRT and concurrent ST (group 1) and 95 patients (131 BM) received SRT alone without concurrent ST (group 2). SRT was planned on a linear accelerator, using volumetric modulated arc therapy. All ST were allowed including chemotherapy (CT), immunotherapy (IT), targeted therapy (TT) and hormonotherapy (HT). Treatment was considered to be concurrent if the timing between the drug administration and SRT did not exceed 1 month. Local control (LC), freedom for distant brain metastases (FFDBM), overall survival (OS) and radionecrosis (RN) were evaluated. Results After a median follow-up of 11.9 months (range 0.7–29.7), there was no significant difference between the two groups. However, patients who received concurrent IT (n = 30) had better 1-year LC, OS, FFDBM but a higher RN rate compared to patients who did not: 96% versus 78% (p = 0.02), 89% versus 77% (p = 0.02), 76% versus 53% (p = 0.004) and 80% versus 90% (p = 0.03), respectively. In multivariate analysis, concurrent IT (p = 0.022) and tumor volume < 2.07 cc (p = 0.039) were significantly correlated with improvement of LC. The addition of IT to SRT compared to SRT alone was associated with an increased risk of RN (p = 0.03). Conclusion SRT delivered concurrently with IT seems to be associated with improved LC, FFDBM and OS as well as with a higher rate of RN.http://link.springer.com/article/10.1186/s12885-020-07491-zStereotactic radiotherapyBrain metastasesSystemic therapiesImmunotherapyRadioimmunotherapy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Morgan Guénolé François Lucia Vincent Bourbonne Gurvan Dissaux Emmanuelle Reygagne Gaëlle Goasduff Olivier Pradier Ulrike Schick |
spellingShingle |
Morgan Guénolé François Lucia Vincent Bourbonne Gurvan Dissaux Emmanuelle Reygagne Gaëlle Goasduff Olivier Pradier Ulrike Schick Impact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastases BMC Cancer Stereotactic radiotherapy Brain metastases Systemic therapies Immunotherapy Radioimmunotherapy |
author_facet |
Morgan Guénolé François Lucia Vincent Bourbonne Gurvan Dissaux Emmanuelle Reygagne Gaëlle Goasduff Olivier Pradier Ulrike Schick |
author_sort |
Morgan Guénolé |
title |
Impact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastases |
title_short |
Impact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastases |
title_full |
Impact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastases |
title_fullStr |
Impact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastases |
title_full_unstemmed |
Impact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastases |
title_sort |
impact of concomitant systemic treatments on toxicity and intracerebral response after stereotactic radiotherapy for brain metastases |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2020-10-01 |
description |
Abstract Background The aim of this study was to determine the safety and efficacy of fractionated stereotactic radiotherapy (SRT) in combination with systemic therapies (ST) for brain metastases (BM). Methods Ninety-nine patients (171 BM) received SRT and concurrent ST (group 1) and 95 patients (131 BM) received SRT alone without concurrent ST (group 2). SRT was planned on a linear accelerator, using volumetric modulated arc therapy. All ST were allowed including chemotherapy (CT), immunotherapy (IT), targeted therapy (TT) and hormonotherapy (HT). Treatment was considered to be concurrent if the timing between the drug administration and SRT did not exceed 1 month. Local control (LC), freedom for distant brain metastases (FFDBM), overall survival (OS) and radionecrosis (RN) were evaluated. Results After a median follow-up of 11.9 months (range 0.7–29.7), there was no significant difference between the two groups. However, patients who received concurrent IT (n = 30) had better 1-year LC, OS, FFDBM but a higher RN rate compared to patients who did not: 96% versus 78% (p = 0.02), 89% versus 77% (p = 0.02), 76% versus 53% (p = 0.004) and 80% versus 90% (p = 0.03), respectively. In multivariate analysis, concurrent IT (p = 0.022) and tumor volume < 2.07 cc (p = 0.039) were significantly correlated with improvement of LC. The addition of IT to SRT compared to SRT alone was associated with an increased risk of RN (p = 0.03). Conclusion SRT delivered concurrently with IT seems to be associated with improved LC, FFDBM and OS as well as with a higher rate of RN. |
topic |
Stereotactic radiotherapy Brain metastases Systemic therapies Immunotherapy Radioimmunotherapy |
url |
http://link.springer.com/article/10.1186/s12885-020-07491-z |
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