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@proceedings{2420968,
author = {Fadrus, Pavel and Vybíhal, Václav and Juráň, Vilém and Rošková, Ivana and ŠprlákováandPuková, Andrea and Kopřivová, Tereza and Keřkovský, Miloš and Lakomý, Radek and Kazda, Tomáš and Hynková, Ludmila and Belanová, Renata and Večeřa, Marek and Hermanová, Markéta and Jančálek, Radim and Šána, Jiří and Slabý, Ondřej and Šlampa, Pavel and Smrčka, Martin},
booktitle = {27th Annual Scientific Meeting and Education Day of the Society-for-Neuro-Oncology (SNO)},
keywords = {BRAIN METASTASES; COMBINED LOCAL TREATMENT},
language = {eng},
title = {COMBINED LOCAL TREATMENT OF BRAIN METASTASES: SURGERY AND POSTOPERATIVE STEREOTACTIC RADIOTHERAPY},
year = {2022}
}
TY - CONF
ID - 2420968
AU - Fadrus, Pavel - Vybíhal, Václav - Juráň, Vilém - Rošková, Ivana - Šprláková-Puková, Andrea - Kopřivová, Tereza - Keřkovský, Miloš - Lakomý, Radek - Kazda, Tomáš - Hynková, Ludmila - Belanová, Renata - Večeřa, Marek - Hermanová, Markéta - Jančálek, Radim - Šána, Jiří - Slabý, Ondřej - Šlampa, Pavel - Smrčka, Martin
PY - 2022
TI - COMBINED LOCAL TREATMENT OF BRAIN METASTASES: SURGERY AND POSTOPERATIVE STEREOTACTIC RADIOTHERAPY
KW - BRAIN METASTASES
KW - COMBINED LOCAL TREATMENT
N2 - INTRODUCTION: Modern comprehensive local treatment of BM provides the possibility of adequate local control while maintaining a satisfactory quality of life. METHODS: Patients after metastasectomy and postoperative radiotherapy treated between 2007-2020 were evaluated. Local control was assessed separately at the site of the operated MM (localPFS) and separately in other parts of the brain (distalPFS). RESULTS: A total of 118 patients were enrolled (70 with WBRT), 54% were women, the median age was 60 years, the median performance status Karnofsky 80%. The most common primary tumor was lung carcinoma (39/118, 33%). Targeted stereotactic radiotherapy was significantly more often indicated in operations performed after 2016 (p < 0.001). In the period 2013-2019, gross total resection was achieved significantly more often (83 vs 64%; p = 0.061). The median follow-up is 49 months. The median overall survival (OS) is 9 months (6.2 - 12), the median localPFS 22 months (14 - unattainable), median distPFS 11 months (6.8 - 27 months), median extracranialPFS 11 months (5.9 - 15). Stratification of patients according to the prognostic index brainmetgpa.com led to significant separation of patients for OS (p = 0.00017). In a multivariate analysis, stereotactic radiotherapy was statistically significant positive prognostic factor for OS compared to WBRT (median OS 17 vs. 5.6 months, HR 0.59, p = 0.018) with no effect on localPFS. CONCLUSION: Our results of comprehensive local treatment of BM are comparable with the results presented by important foreign studies from prestigious oncology centers. We described targeted stereotactic postoperative radiotherapy as an independent positive prognostic factor after brain metastasectomy.
ER -
FADRUS, Pavel, Václav VYBÍHAL, Vilém JURÁŇ, Ivana ROŠKOVÁ, Andrea ŠPRLÁKOVÁ-PUKOVÁ, Tereza KOPŘIVOVÁ, Miloš KEŘKOVSKÝ, Radek LAKOMÝ, Tomáš KAZDA, Ludmila HYNKOVÁ, Renata BELANOVÁ, Marek VEČEŘA, Markéta HERMANOVÁ, Radim JANČÁLEK, Jiří ŠÁNA, Ondřej SLABÝ, Pavel ŠLAMPA a Martin SMRČKA. COMBINED LOCAL TREATMENT OF BRAIN METASTASES: SURGERY AND POSTOPERATIVE STEREOTACTIC RADIOTHERAPY. In \textit{27th Annual Scientific Meeting and Education Day of the Society-for-Neuro-Oncology (SNO)}. 2022.
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