S414
Clinical - Gynaecological
ESTRO 2026
2020; 32:e67–e75.2. Chopra S et al. Int J Radiat Oncol Biol Phys. 2018; 100:1181– 1190.3. Ghosh-Laskar S et al. BMC Cancer. 2021; 21:1027. Keywords: Quality Audit, Patient Compliance, Continuity Digital Poster 955 Factors driving longer survival after brain metastases in ovarian cancer: importance of ECOG, extra-cranial disease control and platinum sensitivity. Enar Recalde Vizcay 1,2 , Mary Patricia Delgado Solano 1 , Lorena Fariñas Madrid 3,4 , Carmen Garcia Duran 3,4 , David Garcia Illescas 4,3 , Roberta Mazzeo 4,3 , Soraya Mico Milla 1,2 1 Radiation Oncology, Vall d'Hebron University Hospital, Barcelona, Spain. 2 Radiation Oncology Group, VHIO - Vall d'Hebron Institute of Oncology, Barcelona, Spain. 3 Gynecological Malignancies Group, VHIO - Vall d'Hebron Institute of Oncology, Barcelona, Spain. 4 Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain Purpose/Objective: Brain metastases (BM) in Ovarian Cancer (OC) are rare, but incidence is increasing as survival rises1. Due to lack of prospective data, WBRT is the main strategy for OCBM management. We aimed to identify risk factors for long survival after BM diagnosis to select who might benefit from alternative approaches. Material/Methods: Single-center, retrospective cohort of 26 patients receiving RT for OCBM between 2015 - 2025. Detailed information from debut disease and BM diagnosis is reported. Clinical and pathological factors were compared between two groups: patients surviving <6 months after BM (<6mBM) diagnosis versus ≥ 6 months (>6mBM). Central progression was deemed platinum-resistant (PR) if diagnosed within 6 months of the last platinum-based chemotherapy.Association between qualitative variables was evaluated (Fisher’s
exact test) and median values were compared (U-Mann-Whitney test). Statistical significance p <0.05. Survival after BM was calculated using Kaplan-Meier method and factors with p<0.1 significance were evaluated in survival analysis. Results: Mean age at OC debut was 57.4 years. Predominant (77%) histology was high-grade serous carcinoma. Of 22 patients with gBRCA information, 8 presented mutations. Patients had received a median of 5 prior treatment lines (46% received PARPi). Median follow-up from debut was 48 months. Median time from diagnosis to BM was 38.5 months. All were symptomatic and required hospitalization (89%). Radiaton treatment included WBRT (81%) or 3-5 fraction fSRS (19%), four of them had prior surgery. Uncontrolled extra-cranial disease (ECD) was present in 76% and 54% had multiple BM. Three BM were considered PR. Twenty-one patients (80%) died. Median survival from BM was 6 months (mean 7.1). Fifteen patients lived >6mBM.Two variables were significantly associated with <6mBM: ECOG 2-3 (OR 0.13, 95%CI=0.02-0.86, p=0.038) and uncontrolled ECD (OR=0.00, p=0.024). All patients with PR BM survived <6m, without significant differences (OR=0.00 p =0.06). No statistically significant differences were found between groups according to histology, gBRCAmut, prior treatment lines, prior PARPi, age >65y, Ca125 duplication and BM number.Significantly better median survival was observed in patients with ECOG 0-1 compared with ECOG 2-3 (7m vs 4m p=0.011) (Fig. 1) and platinum-sensitive BM compared with resistant (7m vs 4m p=0.027) (Fig. 2). Patients with controlled ECD also had better median survival, without reaching statistical significance (18m vs 5m p=0.079).
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