Stereotactic Radiotherapy for Brain Metastases: Predictive Factors of Radionecrosis

Overview

Journal Eur J Med Res

Publisher Biomed Central

Specialty General Medicine

Date 2023 Jul 13

PMID 37443046

Authors

Benoit Calderon

Lea Vazquez

Mohammed Belkacemi

Nicolas Pourel

Affiliations

Soon will be listed here.

Abstract

Purpose: Stereotactic radiotherapy (SRT) is a highly effective approach and represents the current standard of treatment for patients with limited number of brain metastasis (BM). SRT is generally well tolerated but can sometimes lead to radionecrosis (RN). The aim of this study was to identify predictive factors of radionecrosis related to SRT for brain metastasis.

Methods: This retrospective observational cohort study included patients who underwent SRT in the Institut Sainte Catherine between January 1st, 2017 and December 31st, 2020 for the treatment of brain metastasis from any cancer. Individual data and particularly signs of radionecrosis (clinical, imaging, anatomopathological) were collected from electronic medical records. Radionecrosis was defined as the occurrence on MRI of contrast-enhancing necrotic lesions, surrounded by edema, occurring at least 6 months after SRT and localized within fields of irradiation.

Results: 123 patients were included; median age was 66 years. 17 patients (11.8%) developed radionecrosis after a median follow up of 418.5 days [63;1498]. Predictive factors of radionecrosis in multivariate analysis were age under 66 years with a sensitivity of 77% and a specificity of 56%. No other factor as the presence of comorbidities, the number of irradiated metastases, the PTV volume or the volume of irradiated healthy brain were predictive of radionecrosis.

Conclusion: Age at treatment initiation and tumor location seems to be correlated with radionecrosis in patients with brain metastasis treated with SRT. These elements could be useful to adapted radiation therapy.

Citing Articles

Prediction of radiologic outcome-optimized dose plans and post-treatment magnetic resonance images: A proof-of-concept study in breast cancer brain metastases treated with stereotactic radiosurgery.

Pandey S, Kutuk T, Abdalah M, Stringfield O, Ravi H, Mills M Phys Imaging Radiat Oncol. 2024; 31:100602.

PMID: 39040435 PMC: 11261135. DOI: 10.1016/j.phro.2024.100602.

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