KEY TAKEAWAYS
- The study aimed to investigate the association between SRT efficacy and PEV extent in patients with MBM.
- Results showed that a larger PEV was associated with a less favorable outcome to SRT in patients with melanoma brain metastases.
Stereotactic radiotherapy (SRT) is a well-established treatment for melanoma brain metastases (MBM). Recent studies suggest that perilesional edema volume (PEV) may negatively impact the effectiveness of radiotherapy in treating brain cancer metastases.
Mariya Yavorska and the team aimed to investigate the association between SRT efficacy and PEV extent in MBM.
This retrospective study analyzed medical records from January 2020 to September 2023. The study included patients with up to 5 measurable MBMs, intracranial disease as per RANO/iRANO criteria, and who were on low-dose corticosteroids. Baseline neuroimaging was assessed using MRI scans, and PEV was analysed using 3D Slicer software. SRT plans were created based on MRI-CT fusion, delivering 18–32.5 Gy in 1–5 fractions.
The study’s outcomes included intracranial objective response rate (iORR) and survival measures (L-iPFS and OS). Statistical analysis involved decision tree analysis and multivariable logistic regression, adjusting for clinical and treatment variables.
The study analyzed 72 patients with 101 MBMs, with an average age of 68.83 years. The iORR was 61.4%, with 21.8% achieving a Complete Response (CR) and 39.6% achieving a Partial Response (PR). PEV showed a correlation with KPS, BRAF status, and treatment response.
Decision tree analysis determined a PEV cut-off value of 0.5 cc, with lower PEVs predicting better responses (AUC = 0.82, sensitivity: 86.7%, specificity: 74.4%). Patients with PEV ≥ 0.5 cc had lower response rates (iORR 44.7% vs. 63.8%, P< 0.001). The median OS was 9.4 months, while the median L-iPFS was 27 months. PEV significantly impacted survival outcomes.
The study found that a larger PEV was associated with a less favourable outcome to SRT in patients with MBM.
Open access funding provided by Università degli Studi di Siena within the CRUI-CARE Agreement.
Source: https://link.springer.com/article/10.1007/s11060-024-04818-9
Yavorska M, Tomiciello M, Antonio S, et al. (2024). “Predictive value of perilesional edema volume in melanoma brain metastasis response to stereotactic radiosurgery.” J Neurooncol. 2024. doi:10.1007/s11060-024-04818-9.
