P11.57.B Combined surgery and radiotherapy for brain metastases. Retrospective analysis of a consecutive cohort of 118 patients

Abstract Background Despite current advances in systemic therapy for brain metastases, neurosurgery remains the preferred method of choice patients with limited metastases. Postoperative radiotherapy indicated to reduce risk local recurrence is recommended all after surgery. The aim this retrospective study describe clinical characteristics and survival outcomes consecutive cohorts treated by combined treatment. Material Methods Clinical data were retrieved from electronic medical records who underwent surgery metastases between 2007 2019. All postsurgery radiotherapy. Local progression free (localPFS) evaluated control at operated site. DistalPFS other parts brain. Univariable multivariable analysis was performed. Median follow-up 49 months. Results A total 118 included (54% women, median age 60 years, Karnofsky index 80% time radiotherapy). Single metastasis 66%, while 11% presented more than 3 most common primary diagnosis lung cancer (33%) breast (20%). Radical achieved 92/117 (79 % patients). In total, only 48/118 (41%) targeted (mostly fractionated stereotactic 25Gy 5 fractions). Significantly (p<0.001) during 2016-2019 (45/48) compared 2007-2015 period (3/48). 20% those whole (WBRT) had a special technic hippocampal sparing WBRT simultaneous integrated boost remaining overall (OS) 9 months (6.2 - 12), localPFS 22 (14 not reached), distalPFS 11 (6.8 27) extracranialPFS (5.9 15). significant (p=0.00017) difference OS grouping according Graded prognostic assessment (brainmetgpa.com). better cohort (17months) vs. (5.6 months; p=0.00069) no PFS, distal PFS or extracranialPFS. Multivariable revealed type radiotherapy, tumor, number 1-2 possibility discontinue corticosteroids be independent variables OS. Conclusion Targeted tumor bed metastasectomy associated improved our cohort. Stereotactic should workplaces adequate technology. Supported Ministry Health Czech Republic AZV, NV18-03-00469 NV18-03-00398.