S912
Clinical - Mixed sites & palliation
ESTRO 2026
Alessia Pellerino 5 , Francesco Bruno 5 , Alessandro Della Puppa 3 , Eleonora Rosati 6 , Mauro Loi 1 , Carlotta Becherini 1 , Lorenzo Livi 1 1 Radiation Oncology Unit - Careggi Hospital, University of Florence, Florence, Italy. 2 Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA, University of Florence, Florence, Italy. 3 Department of Neurosurgery, Careggi University Hospita, University of Florence, Florence, Italy. 4 Department of Oncology, Radiation Oncology, University and City of Health and Science Hospital, Turin, Turin, Italy. 5 Division of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Turin, Italy. 6 Neurology Unit - Careggi Hospital, University of Florence, Florence, Italy
Purpose/Objective: Stereotactic radiosurgery (SRS) represents a
Conclusion: Early seizures after SRS for brain metastases are relatively uncommon, occurring in a small proportion of seizure-naïve patients. Seizure risk is primarily determined by disease burden, as reflected by total irradiated volume and lesion number at diagnosis, while technical radiotherapy parameters do not appear to influence incidence. A prior diagnosis of epilepsy remains a strong risk factor for early post-SRS seizures. Keywords: SRS, brain metastases, epilepsy Comparative effectiveness of SRS/SRT versus HA- WBRT for 5 to 15 brain metastases: a propensity score analysis Wannit Witoonchart 1 , Rawee Ruangkanchanasetr 2 1 Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand. 2 Department of Diagnostic and Therapeutic Radiology, amathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand Digital Poster 4212
cornerstone in the treatment of brain metastases, enabling precise lesion targeting while minimizing exposure to adjacent normal tissue. Although early onset seizures are a recognized complication of SRS, their true incidence and associated risk factors remain poorly defined. Material/Methods: We conducted a retrospective multicenter study involving 195 patients treated with SRS for brain metastases at two Italian neuro-oncology centers between 2020 and 2022. Clinical, radiological, and treatment-related variables were analyzed to assess seizure incidence and potential predictive factors. Survival analysis was conducted, evaluating potential impact of seizure on overall survival (OS). Results: Among patients without a prior history of epilepsy, the incidence of early post-SRS seizures was 3.5% (6/169). Conversely, patients with a diagnosis of brain tumor- related epilepsy had a higher seizure rate (RR=5.2, p<0.01). n multivariate analysis restricted to seizure- naïve patients, both total irradiated volume (OR 1.10, 95% CI 1.01–1.20, p=0.03) and number of lesions at diagnosis (OR 1.39, 95% CI 1.02–1.88, p=0.04) were independently associated with seizure occurrence. No significant correlation emerged with primary tumor type, radiotherapy dose, or treatment platform (Gamma Knife vs LINAC). Early post-SRS seizures had no significant impact on survival outcomes (p=0.29), with a median OS of 23 months (IQR: 20-31).
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