Gustavo Viani: ESTRON Trial – Can We Skip WBRT After Brain Met Resection?
Gustavo Viani, Associate Professor at Faculty of Medicine of Botucatu, São Paulo State University (UNESP), shared on LinkedIn about recent paper published in Neuro-Oncology.
“ESTRON Trial: Can We Skip WBRT After Brain Met Resection?
Objective
- Compare hypofractionated stereotactic RT (HFSRT, 35 Gy/7 fx) vs. whole-brain RT (WBRT, 30 Gy/10 fx) after brain metastasis resection
- Assess intracranial control, toxicity, and neurocognitive outcomes
Methods
- Phase 2, randomized, single-center, 54 patients
- ≤10 additional unresected metastases allowed
- HFSRT: Robotic radiosurgery, 3 mm CTV margin
- WBRT: 3D-CRT, no hippocampal avoidance
- Primary endpoint: Intracranial progression-free survival (ic-PFS)
- Secondary endpoints: Local control (LC), overall survival (OS), leptomeningeal disease (LMD), toxicity (CTCAE v5.0), neurocognition (HVLT-R)
Key Results
- 2-yr LC: 94% (HFSRT) vs. 85% (WBRT)
- Toxicity: 54 TRAEs (HFSRT) vs. 115 (WBRT)
- Alopecia in 89% WBRT vs. 0% HFSRT
- Better neurocognitive preservation with HFSRT; cognitive improvement over time vs. decline in WBRT
- LMD: 27% (HFSRT) vs. 9% (WBRT)
- OS median: 17.8 vs. 27.0 months (NS)
Takeaway
- HFSRT provides excellent local control and lower toxicity while preserving cognition
- Higher LMD risk requires vigilant MRI follow-up for early detection and salvage.”
Title: Hypofractionated Stereotactic Radiotherapy versus Whole-Brain Radiotherapy following Brain Metastasis Resection – Results of the ESTRON Randomized Phase 2 Trial
Authors: Rami A El Shafie, Denise Bernhardt, Thomas Welzel, Annabella Schiele, Daniela Schmitt, Paul Thalmann, Sinem Erdem, Tanja Eichkorn, Angela Paul, Kristin Lang, Laila König, Fabian Weykamp, Sebastian Adeberg, Adriane Lentz-Hommertgen, Cornelia Jäkel, Farastuk Bozorgmehr, Michael Thomas, Anja Sander, Meinhard Kieser, Jürgen Debus, Stefan Rieken
Read The Full Article at Neuro-Oncology.
More posts featuring Gustavo Viani.
-
Challenging the Status Quo in Colorectal Cancer 2024
December 6-8, 2024
-
ESMO 2024 Congress
September 13-17, 2024
-
ASCO Annual Meeting
May 30 - June 4, 2024
-
Yvonne Award 2024
May 31, 2024
-
OncoThon 2024, Online
Feb. 15, 2024
-
Global Summit on War & Cancer 2023, Online
Dec. 14-16, 2023