S914
Clinical - Mixed sites & palliation
ESTRO 2026
risk but data from literature supporting its use are not robust. This study aimed to explore the correlation between several dosimetric parameters (V12, V14, V16, V18) and RN risk. Material/Methods:
course, likely due to the relatively advanced median age of the population that could have some difficulties in the self-completion of questionnaires. Further strategies are therefore needed to improve participation and data completeness during the follow- up period. Keywords: Protontherapy Registry
Digital Poster Highlight 4244 BRAIN RADIONECROSIS RISK DUE TO
RADIOSURGERY FOR BRAIN METASTASES: VIRTUOSE TRIAL, A RETROSPECTIVE MULTICENTRIC STUDY OF BRAIN TUMOR GROUP OF AIRO Fiammetta Meacci 1 , Lucia Pia Ciccone 1 , Camilla Delli Paoli 2 , Martina Cantarella 3 , Noemi Giannini 4 , Lorena Draghini 5 , Francesca Giugliano 6 , Federico Camilli 7 , Valentina Borzillo 8 , Giulia Stocchi 9 , Sara Cassani 10 , Simona Mercogliano 8 , Alessio Bruni 9 , Rossella Di Franco 8 , Cesare Guida 6 , Marco Lupattelli 7 , Bianca Santo 11 , Angela Sardaro 11 , Saverio Caini 12 , Fabio Trippa 5 , Serenella Russo 13 , Simona Borghesi 14 , Marco Stefanacci 10 , Fabiola Paiar 4 , Silvia Scoccianti 1 1 Radioterapia, Azienda USL Toscana Centro, Bagno a Ripoli (FI)), Italy. 2 Radioterapia, Azienda USL Toscana Centro, Bagno a Ripoli (FI), Italy. 3 Radioterapia, Pisa University Hospital, Pisa, Italy. 4 Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy. 5 S.C. Radioterapia Oncologica, Azienda Ospedaliera Santa Maria Terni, Terni, Italy. 6 Radioterapia, ASL Napoli 1 Ospedale del Mare, Napoli, Italy. 7 Sez. Radioterapia Oncologica, Università degli Studi e Azienda Ospedaliera di Perugia, Perugia, Italy. 8 Radioterapia Oncologica, Istituto Nazionale Tumori - IRCCS- Fondazione G. Pascale, Napoli, Italy. 9 U.O Radioterapia Oncologica, Azienda Ospedaliero- Universitaria di Modena - Policlinico, Modena, Italy. 10 Radioterapia Oncologica, Ospedale San Jacopo, Pistoia, Italy. 11 U.O Radioterapia Oncologica, Ospedale Vito Fazzi, Lecce, Italy. 12 S.S. Epidemiologia Molecolare e degli Stili di Vita, Istituto per lo studio, la prevenzione e la rete oncologica (ISPRO), Firenze, Italy. 13 Fisica Medica, Azienda USL Toscana Centro, Bagno a Ripoli (FI), Italy. 14 U.O.C Radioterapia, Azienda USL Sud Est, Arezzo, Italy
This retrospective multicentric study enrolled 242 patients (pts) in 10 italian centers, treated from 2018 to 2023, who underwent regular clinical and radiological follow-up with a minimum follow-up of 6 months. Severity of RN was scored according to CTCAE v5.0 criteria. Dosimetric values regarding brain parenchyma were collected both including (tissue-Vx) and excluding (brain-Vx) the GTV. Cox regression analysis was used to identify the dosimetric parameters related to the risk of RN. Results: One hundred and ninety- nine treatments were LinAc- based (82.2%) and CyberKnife was used in 43 pts (17.8%). The median number of BM treated was 1 (1-4) with a median total dose of 21Gy (15-26). The median volume of the largest lesion was 0.92 cc (0.04-14.3) and the median cumulative intracranial BM volume was 1.25 cc (0.07-17.7). Local control and freedom from new brain metastases rates were 72.3% and 46.7%, respectively. The median local control was 15 months (1-86), the median distant intracranial free survival is 12.5 months (1-81). Median OS was 44 months (3-324). Two hundred and six pts (85,1%) did not experience RN of any grade. Morphological MRI, multiparametric MRI and PET-DOPA were used to diagnose RN in 7, 27 and 2 cases, respectively. Dosimetric data regarding 382 lesions were collected. RN of any grade was recorded in 36 cases (G1 n=17, G2 n=13, G3 n=6). All the patients who had G3 RN were treated on a single BM. At Cox regression
Purpose/Objective: Brain radionecrosis (RN) is the most severe
complication of radiosurgery (RS) for brain metastases (BM). V12, representing brain volume receiving 12Gy, is the most used dosimetric parameter to predict RN
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