S940
Clinical - Non-malignant & functional radiotherapy
ESTRO 2026
Stefan Jaschik 1 , Maria Nitzsche 1 , Helene Ehlers 2 , Melanie Grehn 2 , Luuk H. G. van der Pol 3 , Felix Mehrhof 4 , Roland Merten 5 , David Duncker 6 , Marian Christoph 7 , Maciej Dawid 7 , Mathieu Kruska 8 , Jens Fleckenstein 9 , Moritz Sinner 10 , Stefanie Corradini 11 , Micaela Ebert 12 , Annika Lattermann 13 , Dirk Rades 14 , Adrian Zaman 15 , David Krug 16 , Martin F. Fast 3 , Roland R. Tilz 17 , Gunther Klautke 1 , Evgeny Lian 15 , Oliver Blanck 2 , Judit Boda-Heggemann 9 1 Department of Radiation Oncology, Klinikum Chemnitz, Chemnitz, Germany. 2 Department of Radiation Oncology, University Hospital Schleswig- Holstein, Kiel, Germany. 3 Department of Radiotherapy, University Medical Center Utrecht, Utrecht, Netherlands. 4 Department for Radiation Oncology, Charité University Medicine Berlin, Berlin, Germany. 5 Department of Radiation Oncology, Hannover Medical School, Hannover, Germany. 6 Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. 7 Department of Cardiology, Klinikum Chemnitz, Chemnitz, Germany. 8 Department of Cardiology, Medical University Hospital Heidelberg, Heidelberg, Germany. 9 Department of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. 10 Department of Cardiology, LMU Munich, Munich, Germany. 11 Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany. 12 Division of Electrophysiology, Department of Internal Medicine and Cardiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany. 13 Clinic of Radiation Oncology, University Hospital Carl Gustav Carus, Dresden, Germany. 14 Department of Radiation Oncology, University Medical Center Schleswig- Holstein, Lübeck, Germany. 15 Department of Internal Medicine III (Cardiology and Intensive Care Medicine), University Medical Center Schleswig-Holstein, Kiel, Germany. 16 Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 17 Department of Rhythmology, University Hospital Schleswig-Holstein, Lübeck, Germany Purpose/Objective: STereotactic Arrhythmia Radioablation (STAR) is a safe and effective bail-out therapy for refractory ventricular tachycardia (VT). The STOPSTORM.eu consortium has been established as a STAR registry to harmonize patient selection criteria and optimize treatment strategies. For this analysis, STAR treatments from 7 German centers were evaluated on current pattern-of- practice regarding patient selection and radiotherapy planning. Material/Methods: Patient characteristics and all treatment parameters were extracted from the STOPSTORM database in 07/2025. Information on patient characteristics, target
from April 2020 to December 2024, in one tertiary center (Lille University Hospital, France). The target volume delineation was performed after multimodal integration of data from electrophysiological maps and substrate imaging (MRI and CT scan). STAR was performed using the CyberKnife® system. The primary outcome included VT burden assessment. The blanking period was defined as 6 weeks. Results: From April 2020 to December 2024, 33 patients underwent STAR to treat refractory VT (mean age 66 y.o±10.9; 76% were males; 67% were presenting an ischemic cardiomyopathy; mean left ventricular ejection fraction was 2.5±9.0%; 82% had a history of electrical storm (ES)). Dose prescription was 20Gy at 80% isodose except for 5 patients treated with 25 Gy. Mean CTV and PTV were 47.5±32.5 and 89.2±73.0 cc. All but one patient were treated with Synchrony®, with the defibrillator lead serving as a fiducial marker. CTV to PTV margins were 3mm, except in one patient treated with ITV, where a 5mm margins was used. The median follow-up was 15 months (IQR 9–37). At one year, the VT burden decreased significantly by 71.4% (median value, IQR 32–100, P = 0.0051). Long-term recurrence rates of VT were 40,1% (25,0–61,37, 95IC) at 6 months, and 71.5% (53.78-87.0) at 12 months. Long- term recurrence rates of ES were 24.1% (12.31–44.1) at 6 months, and 38.8% (23.6–59.1) at 12 months. 24,5% of patients died at 1 year, and 48% of patients at the end of the follow-up (half of them of rythmic causes). No significant change in left ventricular ejection fraction was detected during follow-up. Four pericardial effusions occurred, and one of them required a pericardial drainage. Four patients died during the blanking period because of a refractory ES. One radiation-induced pneumonitis occured, with favorable outcome. Conclusion: STAR is associated with a significant reduction of VT burden despite a high rate of long-term recurrences, and a low rate of adverse events. References: [1] Goethals E, Vankelecom E, De Roover R, Poels K, Draulans C, Dries E, et al. Stereotactic arrhythmia radioablation in patients with refractory ventricular tachycardia: a systematic review and meta-analysis. Heart Br Card Soc 2025:heartjnl-2025-325805. https://doi.org/10.1136/heartjnl-2025-325805. Keywords: Ventricular Arrythmia
Mini-Oral 624
Patterns of practice for STereotactic Arrhythmia Radioablation (STAR) for ventricular tachycardia: the German cohort within the STOPSTORM consortium
Made with FlippingBook - Share PDF online