Journal article
SURG-02. Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (SRS) as a treatment strategy for brain metastasis that recurred locally after initial radiosurgery (BMRS): a collaborative institutional experience
Neuro-oncology advances, v 3(Supplement_3), pp iii23-iii23
09 Aug 2021
Abstract
Abstract
Introduction
In independent clinical trials, ~30% of brain metastases recur locally after radiosurgery (BMRS). For these lesions, treatment with stereotactic laser ablation (SLA, also known as laser interstitial thermal therapy (LITT)) alone achieves a 12-month local control (LC12) of 54–85% while repeat SRS achieved LC12 of 54–79%. Here, we report favorable outcomes for BMRS treated with SLA followed by consolidation radiosurgery (SLA/cSRS).
Methods
Clinical outcome of 18 patients with 19 histologically confirmed BMRS treated with SLA followed by consolidation SRS and >3 months follow-up were collected retrospectively across three institutions. Local control was defined as stability or decrease in contrast-enhancing (CE) and FLAIR volume.
Results
SLA achieved ablation of 73–100% of the BMRS CE volumes. Consolidation hypo-fractionated radiosurgery (5 Gy x 5 or 6 Gy x 5) was carried out 16–40 days post-SLA (median of 26 days). With a median follow-up of 185 days (range: 93–1367 days) and median overall survival (OS) of 185 days (range: 99–1367 days), 100% LC12 was achieved. 13/18 (72%) patients that required steroid therapy prior to SLA/cSRS were successfully weaned off steroid by three months post-SLA/cSRS. Post-SLA, KPS declined for 3/19 (16%) patients and improved for 1/19 (5%) patients. No KPS changes occurred subsequent to consolidation SRS. There were no 30-day mortalities or wound complications. Two patients required re-admission within 30 days of SRS (severe headache that resolved with steroid therapy (n=1) and new-onset seizure (n=1)). Except for two patients who suffered histologically confirmed, local failure at 649 and 899 days, all other patients are either alive (n=5) or died from systemic disease progression (n=11). None of the treated patients developed symptomatic radiation necrosis.
Conclusions
This collaborative institutional experience support efficacy and safety of SLA followed by consolidation SRS as a treatment for BMRS. The treatment strategy warrants further investigations.
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Details
- Title
- SURG-02. Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (SRS) as a treatment strategy for brain metastasis that recurred locally after initial radiosurgery (BMRS): a collaborative institutional experience
- Creators
- Isabela Pena-Pino - University of MinnesotaJun Ma - University of MinnesotaYusuki Hori - Cleveland ClinicElena Fomchenko - Yale Cancer CenterKathryn Dusenbery - University of MinnesotaMargaret Reynolds - University of MinnesotaChristopher Wilke - University of MinnesotaJianling Yuan - University of MinnesotaGene Barnett - Cleveland ClinicVeronica Chiang - Yale Cancer CenterAlireza Mohammadi - Cleveland ClinicClark Chen - University of Minnesota
- Publication Details
- Neuro-oncology advances, v 3(Supplement_3), pp iii23-iii23
- Publisher
- Oxford University Press
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Other Identifier
- 991022004963004721