S857
Clinical - Mixed sites & palliation
ESTRO 2026
Digital Poster 22
Survival prediction using temporal muscle thickness measurements on cranial MRIs in patients with newly diagnosed brain metastases Emilia Barsha 1 , Kiril Zhelev 1 , Manoela Cholakova 1 , Svetlana Bilyukova 1 , Dilyana Palamudova 1 , Hristina Ivanovska 2 , Hristo Spasov 3 , Rostislav Manev 4 , Maria Mihaylova-Hristova 5 , Iglika Mihaylova 6 1 Radiotherapy, University Hospital Deva Maria, Burgas, Bulgaria. 2 Radiotherapy, Complex Oncology Center, Varna, Bulgaria. 3 Medical Oncology, University Hospital Deva Maria, Burgas, Bulgaria. 4 Medical Oncology, University Hospital St. Marina, Varna, Bulgaria. 5 Nuclear Medicine, National Oncology Hospital, Sofia, Bulgaria. 6 Radiotherapy, National Oncology Hospital, Sofia, Bulgaria Purpose/Objective: The aim of this study was to assess the prognostic significance of temporal muscle thickness (TMT) in patients with brain metastases. Material/Methods: We retrospectively analyzed TMT on magnetic resonance (MR) images at diagnosis of brain metastasis in independent cohort of 147 non-small cell lung cancer. Results: The Kruskal-Wallis one-way ANOVA analysis of variance showed that there were significant differences in low GPA (0.5-1 and 1.5-2) between (4.0 ± 0.56 vs 4.3 ± 0.68; p = 0.044) and low TMT and high GPA (2.5-3 and 3.5-4) and high TMT (4.8 ± 0.58 vs 4.7 ± 0.33; p = 0.042). Moreover, using ordinal logistic regression analysis, after adjustment for age and sex, having low TMT were associated with an increased likelihood of having lower GPA (estimate = 0.59, 95% CI = 0.27–1.30, p = 0.006; estimate = 0.12, 95% CI = 0.24– 0.54, p = 0.007). Explicitly, TMT prediction of survival was stable, with a reduced risk of death of 41%, with every additional millimeter of TMT. Conclusion: In patients with newly diagnosed brain metastases from NSCLC, TMT is an independent predictor of survival and is readily and reproducibly measurable on routine MRIs. TMT has the potential to enhance the definition of vulnerable patient populations, thereby facilitating the selection of patients for clinical trials or therapeutic measures. Keywords: Brain metastasis, Radiosurgery, Sarcopenia
Digital Poster Highlight 108
Quality of Life After Palliative Radiation Therapy: Secondary Analysis of a Prospective Study of Bone vs. Non-Bone Lesions Yutaro Koide, Kenta Nimura, Masamune Noguchi, Tomoki Kitagawa, Takahiro Aoyama, Shingo Hashimoto, Hiroyuki Tachibana, Takeshi Kodaira Radiation Oncology, Aichi Cancer Center, Nagoya, Japan Purpose/Objective: This study compared quality-of-life (QoL) changes following palliative radiotherapy (RT) between patients with painful bone metastases and those with painful non-bone lesions. Material/Methods: A total of 440 patients with 678 lesions (541 bone metastases and 137 non-bone lesions) who underwent palliative RT between 2021 and 2023 were included, using the same cohort as a previous studies assessing pain response [1-3]. From 2,756 patient- reported European Organisation for Research and Treatment of Cancer QLQ-C15-PAL and QLQ-BM22 questionnaires, collected simultaneously with pain assessments, mean scores for each C15-PAL subscale at baseline and 2, 4, and 12 weeks post-RT were analyzed. The primary endpoint was the intergroup difference in mean change of global health status (GHS)/QoL scores from baseline to 12 weeks between the groups. Secondary endpoints included the differences in other subscales and the improvement rates in each subscale. Results: The median follow-up time was 21 weeks for pain response and 13 weeks for QoL. Baseline QoL data were available for 97% (656/678) of lesions and 74% (338/458) at 12 weeks, with similar completion rates between groups. At baseline, the non-bone group had better GHS/QoL (45 vs. 39, P = 0.015) and physical functioning (76 vs. 67, P = 0.02), but slightly worse scores in the pain subscale (52 vs. 51, P = 0.005). At 12 weeks, no significant differences were observed between the groups across all QoL subscales, including GHS/QoL (52 vs. 49, P = 0.41). Regarding changes over time, dyspnea worsened in the bone metastasis group (+9 vs. +1, P = 0.017), while changes in GHS/QoL (+5 vs. +1, P = 0.27) and other subscales were not significantly different. Improvement rates across all subscales, including GHS/QoL (39% vs. 48%, P = 0.44), were not significantly different between groups. Conclusion:
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