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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

5631 - Stereotactic radiation therapy in melanoma brain metastasis: a European, multicentric cohort

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

adrien paix

Citation

Annals of Oncology (2018) 29 (suppl_8): viii442-viii466. 10.1093/annonc/mdy289

Authors

A. paix1, F. Thillays2, F. Courtault-Deslandes3, I. Popp4, H. Herrscher5, J. Biau6, O. Briard7, A. Grosu8, G. Noël9

Author affiliations

  • 1 Radiation oncology, Centre Paul Strauss Centre de Lutte contre le Cancer, 67065 - Strasbourg/FR
  • 2 Radiotherapy, Institut cancérologique de l'ouest, Saint Herblain/FR
  • 3 Radiotherapy, Centre Georges-Francois Leclerc, Dijon/FR
  • 4 Klinik Für Strahlenheilkunde, Universitätsklinikum Freiburg, Freiburg/DE
  • 5 Medical Oncology, University Hospital Strasbourg, 67000 - Strasbourg/FR
  • 6 Radiotherapy, Centre Jean Perrin, Clermont-Ferrand/FR
  • 7 Radiotherapy, Centre Henry Kaplan – Centre Hospitalier Universitaire de Tours, Tours/FR
  • 8 Radiation oncology, Univeristy of Freiburg, 79106 - Freiburg/DE
  • 9 Radiotherapy, Centre Paul Strauss, Strasbourg/FR
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Resources

Abstract 5631

Background

Brain metastases are frequent in patients with melanoma and stereotactic radiotherapy is one of the main treatment options. We report the efficacy and safety of hypofractionated stereotactic radiation therapy (HFSRT) and stereotactic radiosurgery (SRS), and its role in melanoma brain metastasis management.

Methods

On behalf of the French-speaking neuro-oncologist association (ANOCEF), we retrospectively collected clinical data of 150 patients and 299 brain metastases from melanoma treated with SRS or HFRSRT in 6 radiation oncology departments in France and in Germany. The primary endpoint was the response to the treatment according to RANO criteria. Secondary endpoints were overall survival (OS).

Results

We conducted a Bayesian multivariate logistic regression for treatment response probability. Age, control of disease and stereotactic radiosurgery have an odds ratio (OR) of 1.02 [1.00 – 1.05], 4.61 [1.15 – 13.24] and 4.33 [0.94 – 13.38] respectively and a probability of being > 1 of 94%, 99% and 97% respectively. BRAF mutation, time between dosimetric MRI and treatment, Ipilimumab administration, multiple brain metastases and WHO performans status have an OR of 0.559 [0.21 – 1.33], [0.79 – 0.94], 0.57 [0.17 – 1.39], 0.41 [0.11 – 1.04] and 0.63 [0.25 – 1.28] respectively and a probability of being < 1 of 91%, 100%, 91%, 97% and 91% respectively. Median OS was 11 months [8 – 20] and the multivariate Cox analysis estimated a Hazard ratio of 0.37 (p = 0.007) and 0.8 (p = 3.7E-6) for the control of the disease and the brain progression-free survival respectively.

Conclusions

We report the results of one of the largest cohort of patients treated with SRS and HFSRT for melanoma brain metastases. Our analysis suggests that the age of the patient, the control of the disease and SRS are associated with higher response probability while BRAF mutation, the time between dosimetric MRI and treatment, Ipilimumab administration, multiple brain metastases and poor WHO PS are associated with lower response probability.

Clinical trial identification

Legal entity responsible for the study

Association des neuro-oncologues de langue Française (ANOCEF).

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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