S889
Clinical - Mixed sites & palliation
ESTRO 2026
0.001) were identified as independent predictors of shorter OS. In a landmark analysis from the time of initial response assessment, median OS was not reached in patients who achieved CR, compared to 7.8 months in those without CR (p < 0.001, log-rank test; Figure 1).
Mini-Oral 3048
Long-term survivors’ characteristics in patients with brain metastases treated with SRS studied in the COIMBRA prospective cohort NL67206.041.18 Joyce Baremans 1 , Fia Cialdella 1 , Celeste C. Hinkert 1 , Joost J.C. Verhoeff 2 , Martine J.E. van Zandvoort 3 , Marielle E.P. Philippens 1 , Eva E. van Grinsven 3 1 Radiotherapy, UMC Utrecht, Utrecht, Netherlands. 2 Radiotherapy, Amsterdam UMC, Amsterdam, Netherlands. 3 Neurology & Neurosurgery, UMC Utrecht, Utrecht, Netherlands Purpose/Objective: Brain metastases (BM) occur in approximately 30% of the adult cancer population and is still growing1. Historically, this group has a median survival of 3-7 months2. However, knowledge and prediction of their survival is mostly based on cohorts treated with whole brain radiotherapy (WBRT) whereas treatment of choice nowadays is stereotactic radiosurgery (SRS). Moreover those cohorts are not aligned with recent advances in (systemic) therapies2-4. Consequently, knowledge on current patient characteristics, overall survival (OS) and long-term survivors (LTS) - those living beyond one year following radiotherapy - remains limited. Therefore, this study aimed to characterize these patients and identify factors associated with survival outcomes. Material/Methods: Clinical data were collected from patients enrolled in the observational, prospective Cohort for patient- reported Outcomes, Imaging and trail inclusion in Metastatic BRAin disease (COIMBRA) study at the University Medical Center Utrecht between May 2019 and December 2023. Only patients undergoing first- time SRS for BM were included. OS was calculated from the initiation of SRS to the date of death or last follow-up. Kaplan–Meier survival curves and Cox proportional hazards models were used to assess survival and the correlation with baseline (pre-SRS) characteristics. Results: Over half of the 400 patients were LTS. Median OS in the total cohort was 14 months, ranging from 7 months in patients with gastrointestinal primary tumors to 35.2 months in those with melanoma (Figure 1). Older age, multiple BM (2-4 and >10 vs. 1), unfavorable primary tumor site and lower KPS (<70)
Conclusion: In patients with large symptomatic brain metastases treated with SRT, initial tumor shrinkage was strongly associated with neurological symptom improvement and better OS outcomes. Initial tumor response may serve as a clinically relevant indicator of efficacy and prognosis. References: [1] Soni V et al. Determining the frequency and underlying factors of brain metastasis symptoms. Int J Radiat Oncol Biol Phys. 2020 Nov 1; 108(3 Suppl): e679. Poster Q&A Session, presented at ASTRO Annual Meeting, Miami, FL, Oct 2020.[2] Lin NU et al. Response assessment criteria for brain metastases: proposal from the RANO group. Lancet Oncol. 2015 Jun; 16(6): e270–e278. Keywords: Stereotactic radiotherapy, Brain metastases
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