S1044
Clinical – Sarcoma, skin cancer, malignant melanoma
ESTRO 2026
The analysis therefore suggests that: IB before SRT predisposes to a higher likelihood of post-SRT bleeding [p-value 0.29]. The p-values for treatment with ICIs concomitantly [0.5] or not concomitantly [0.9] with SRT suggest that the modality of administration ICI+SRT is not a significant predictor of IB. P-values for treatment with concomitant and non- concomitant TT suggest that discontinuation appears to have a slightly positive, but non-significant on the toxicity profile [0.5]. Patients taking anticoagulants have a higher risk of post-SRT bleeding, [p-value 0.17] (the only trend in our study). Conclusion: For MBM combining SRT with immunotherapy or targeted therapy represents an exciting approach related on individual patient characteristics and tumor-board decisions. Data supporting a definitive impact in practice are eagerly awaited Keywords: sbrt brain metastases melanoma ici tt Proffered Paper 3289 Tailoring Radiotherapy Margins in Primary Extremity Soft Tissue Sarcoma: Evidence for Safety and Efficacy from SU2C-SARC032 Siyer Roohani 1,2 , Reinhardt Krcek 1,3 , Yvonne M. Mowery 4,5 , Karla V. Ballmann 6,7 , Angela M. Hong 8,9 , Scott M. Schuetze 10 , Andrew J. Wagner 11 , Varun Monga 12,13 , Rachel S. Heise 6,14 , Everett J. Moding 15 , Kent J. Weinhold 5,16 , Matt van de Rijn 17 , Brian E. Brigman 5,18 , Richard F. Riedel 5,19 , David G. Kirsch 20,4 1 Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada. 2 Department of Radiotherapy and Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3 Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland. 4 Department of Radiation Oncology, Duke University, Durham, USA. 5 Duke Cancer Institute, Duke University, Durham, USA. 6 Biostatistics Core, SARC, Ann Arbor, USA. 7 Department of Qualitative Health Sciences, Mayo Clinic, Rochester, USA. 8 Department of Radiation Oncology, Chris O’Brien Lifehouse–Royal Prince Alfred Hospital, Sydney, Australia. 9 Faculty of Medicine and Health, University of Sydney, Sydney, Australia. 10 Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, USA. 11 Sarcoma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA. 12 Holden Comprehensive Cancer Center, University of Iowa, Iowa City, USA. 13 Division of Hematology and Oncology, Department of Medicine, UCSF Helen Diller Comprehensive Cancer Center, San Francisco, USA. 14 Department of Population Health Sciences, Weill Cornell Medicine, New York, USA. 15 Department of
Digital Poster 3274 Combination of Stereotactic Radiotherapy with Immunotherapy or TargetedTherapy for melanoma brain metastases. Claudio Scaffidi 1 , Simone Baroni 1 , Rachele Petrucci 1 , Anna Sardo 2 , Paola Critelli 3 , Spinelli Lavinia 4 , Luca Gianello 4 , Marcella Occelli 5 , Anna Maria Merlotti 4 , Nicola Padula 2 , Francesco Spagnolo 6 , Liliana Belgioia 7 , Francesco Lucio 2 , Alessia Reali 8 1 Department of Radiation Oncology, Michele e Pietro Ferrero Hospital, Verduno, Italy. 2 Medical Physics, Michele e Pietro Ferrero Hospital, Verduno, Italy. 3 Department of Radiation Oncology, AO Santa Croce e Carle Hospital, Cuneo, Italy. 4 Department, AO Santa Croce e Carle Hospital, Cuneo, Italy. 5 Medical Oncology, AO Santa Croce e Carle Hospital, Cuneo, Italy. 6 Medical Oncology, IRCCS San Martino Hospital, Genova, Italy. 7 Department, IRCCS San Martino Hospital, Genova, Italy. 8 Department, Michele e Pietro Ferrero Hospital, Verduno, Italy Purpose/Objective: Fractionated Stereotactic Radiotherapy (SRT) may be considered a treatment paradigm for melanoma brain metastases (MBM) and combining SRT with immunotherapy or targeted therapy offers a synergistic approach but potentially higher increased side effects. The optimal sequence is nowadays not clear and our retrospective analysis is a real-data multicentre study that aims to obtain helpful information for clinical practice. Material/Methods: We considered 23 patients (pts) affected by MBM treated with SRT in association with ICI/TT or not in 3 different Radiotherapy Department in Italy between January 2020 and December 2024. For 14 pts SRT was done concurrent with ICI, for 8 pts concurrent with TT (for one pts was a switch therapy after brain progression) and finally 2 pts were off-therapy. We treated 59 MBM, with a median dose of 24 Gy for radiosurgery and 30 Gy for SRT. Results: Median follow-up was 14 months. We recorded 36% of intra-lesion bleeding (IB) and 3% (2 pts) of symptomatic radionecrosis (RN). IB was seen after SRT and in 6 MBM IB occurred with anti-coagulants drugs. RN was reported in 1 pts in TT stopped before SRT- start and treated with radiosurgery, and in 1 pts off- therapy, but with a lot of systemic therapy done before SRT, both these pts were doing anti-coagulants drugs. For others pts TT was stopped before SRT-start and no adverse events (AE) occurred, in 1 case TT was not stopped without AE. No AE were recorded for pts treated with radiosurgery + ICI stopped before RT, except for 1 IB. 52.17% of pts have done SRT + ICI without stop: in this setting we recorded 28% of IB.
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