S1020
Clinical – Paediatric tumours
ESTRO 2026
Maclean 1 , Ashley Poon-King 1 , Sara Walters 4 , James Powell 1,5 1 Clinical Oncology, Velindre Cancer Centre, Cardiff, United Kingdom. 2 Clinical Oncology, South West Wales Cancer Centre, Swansea, United Kingdom. 3 Radiotherapy, Velindre Cancer Centre, Cardiff, United Kingdom. 4 Audit, Velindre Cancer Centre, Cardiff, United Kingdom. 5 School of Medicine, Cardiff University, Cardiff, United Kingdom Purpose/Objective: Velindre Cancer Centre (VCC) has provided regional stereotactic radiosurgery (SRS) service for brain metastases across South, West, and Mid-Wales for the past decade. The aims were to evaluate the survival outcomes of 10 years of service delivery, assess toxicities, and explore differences in outcomes according to primary tumour sites and planning target volume (PTV). Material/Methods: All patients who underwent SRS at VCC between September 2015 and December 2024 were included. Toxicity data were collected prospectively, while demographics, performance status, and disease characteristics were reviewed. Overall survival (OS) was calculated from the date of SRS, and outcomes were compared between patients with common (lung, breast, melanoma & kidney) and uncommon primary tumour sites and according to PTV in those receiving a single SRS course. Results: A total of 470 SRS treatments were delivered to 413 patients. Most patients (71.3%) received a single course, while remaining patients underwent repeat SRS for new or recurrent lesions. Most treatments (65%) targeted a single metastasis; 23% treated two, 10% treated three or more lesions. Lung (44%), breast (18%), melanoma (18%), and kidney (9%) were the most frequent primary sites; less common origins included colorectal, gynaecological, head and neck, and non-renal urological cancers.The median overall survival (mOS) was 11.9 months. Patients treated between 2020–2024 demonstrated improved mOS compared to those treated between 2015-2020 (13.5 vs 11.2 months respectively). mOS varied with intracranial disease burden:11.9 months with a single lesion vs. 7.0 months with four. Patients with common primary tumour sites achieved longer mOS (14.0 vs 7.2 months for uncommon sites) (Table 1).In patients receiving a single SRS course, mOS declined with increasing PTV volume: 10 months for <5 cc, 8.3 months for 5–10 cc, 7.4 months for 10–15 cc, and 6 months for >15 cc (Table 2). The overall median PTV was 6 cc, higher in uncommon versus common primaries (8.15 vs 5.85 cc).Toxicity was minimal, mostly grade 1–2 fatigue or headache, minimal grade 3 events with no grade 4 events.
Conclusion: SRS is an effective, well-tolerated treatment for brain metastases, providing durable intracranial control. The improvement in mOS in patients treated after 2020 may reflect improvements in systemic therapy, patient selection and increasing intracranial surveillance. Outcomes were better for patients with common primaries , whereas poorer survival in uncommon primaries may relate to larger metastases and limited systemic options. Further analysis is underway to analyse recurrence patterns in patients receiving multiple SRS courses. Keywords: Stereotactic radiosurgery
Poster Discussion 4063
Cardiac Exposure in Paediatric and Young Adult Patients Undergoing Contemporary Radiotherapy: A Systematic Review and Meta-Analysis Love Goyal 1,2 , Shweta Sharma 1 , Maria Majeed 1 , Angela Davey 2 , Anna France 1 , Gerard M Walls 3,4 , Ed Smith 1,2 , Marianne C Aznar 2
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