Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display session

699 - Temozolomide Combined with Fractionated Stereotactic Radiotherapy for Large Brain Metastases: A Propensity-matched Study

Date

10 Sep 2017

Session

Poster display session

Topics

Cytotoxic Therapy;  Surgical Oncology;  Radiation Oncology;  Central Nervous System Malignancies

Presenters

Yuchao Ma

Citation

Annals of Oncology (2017) 28 (suppl_5): v109-v121. 10.1093/annonc/mdx366

Authors

Y. Ma, J. Xiao, N. Bi, Q. Liu, Y. Zhang, R. Zhao, S. Yang, Y. Li

Author affiliations

  • Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences (CAMS), 100021 - Beijing/CN
More

Resources

Abstract 699

Background

This study was conducted to investigate the efficacy and safety of temozolomide (TMZ) with fractionated stereotactic radiotherapy (FSRT) for large brain metastases (BMs).

Methods

From 2009 to 2016, 72 patients (pts) with large BMs (diameter>3cm or volume>6cc) undergoing concurrent TMZ and FSRT (Group A, n = 38) or FSRT alone (Group B, n = 34) were compared by using the propensity score matching method at the ratio of 1:1. Finally, 27 pts of each group were matched. FSRT was given by 52-52.5Gy/3.5-4Gy/13-15f, while TMZ was given by 75mg/m2 concurrently. The disease control rate (DCR, CR+PR+SD) was assessed after 2-3 months from treatment. Toxicity was recorded according to CTCAE, v4.0. Local control (LC), intracranial progression-free survival (IPFS), progression-free survival (PFS) and overall survival (OS) were assessed with Kaplan–Meier method and log-rank test.

Results

The median GTV of Group A and B were 19.7cc (6.02-142.81cc) and 15.7cc (6.27-62.35cc), respectively. During treatment, more lesions in Group A shrank greatly and got re-contoured (39 VS 29, p = 0.005), and the median GTV shrinkage rate was 30.5% versus (VS) 23.1%. After 2-3 months of treatment, the DCR was 97.4% (37/38) in Group A and 85.3% (29/34) in Group B (p = 0.064). The median follow-up time was 20.6 months. Before matching, the LC (p = 0.037) and PFS (p = 0.025) of Group A were significantly greater than Group B. IPFS (p = 0.059) and OS (p = 0.059) were marginally longer in Group A. After matching, the median PFS time and 1-year PFS rate of Group A were significantly greater than Group B (12.7m VS 3.3m and 55.2% VS 26.4%, respectively, p = 0.041). The rate of intracranial progression death of Group A was significantly lower (18.2% VS 45.8%, p = 0.04). Both overall survival time and IPFS were also marginally longer in Group A (MST: 23.7m VS 17.5m, p = 0.064; 1y-IPFS: 61.6% VS 40.7%, p = 0.069), while there was no significant difference in 1-y LC (89.8% VS 84.2%, p = 0.23). There was no severe toxicity in both groups (p = 0.623).

Conclusions

The addition of TMZ to FSRT shows advantages in accelerating the shrinkage of large BMs and might improve intracranial control and overall survival, with no increase of toxicities. Further studies with large sample sizes are warranted.

Clinical trial identification

NCT02654106

Legal entity responsible for the study

Cancer Hospital, Chinese Academy of Medical Sciences

Funding

None

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.