A RANDOMISED TRIAL TO OPTIMISE OUTCOMES IN PATIENTS WITH BRAIN METASTASES (AROMA): TRIAL PROPOSAL

Abstract AIMS Brain metastases carry significant morbidity and mortality. The survival of patients with metastatic disease has improved due to systemic therapy advances conferring greater extracranial control. Optimal intracranial local control is probably surgical resection or stereotactic radiosurgery. However, there a cohort for whom this inappropriate, either patient fitness reasons. Traditionally, treatment included whole brain radiotherapy although not been convincingly shown improve quality life. AROMA single-arm phase II study investigating the feasibility delivering novel technique measuring METHOD We have developed modern deliver dose-escalated internal PTV (DE-iPTV) in metas- tases too large SRS. Our previously-published planning demonstrates dosimetric improvements 5 fractions versus WBRT, higher lesion dose lower normal tissue dose. It delivered using standard linear accelerator. In AROMA, their oncologist would normally consider WBRT instead receive DE-iPTV. QoL measures (EQ5D-3L, Barthel, PS) are collected weekly 8 weeks then monthly 6 months. There an MRI at post-radiotherapy. also collecting retrospective observational data on participating centres’ cohort. RESULTS primary outcome completion weeks. Secondary outcomes include lesional response, survival, steroid use. CONCLUSIONS looking DE-iPTV suitable SRS neurosurgery. currently design setup phase.