RADT-63. IMPACT OF CLINICAL FACTORS ON THE OVERALL SURVIVAL OF BRAIN METASTASES PATIENTS TREATED WITH STEREOTACTIC RADIOSURGERY USING VARIAN HYPERARCTM - SINGLE UK TERTIARY CENTRE EXPERIENCE

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Abstract BACKGROUND Varian HyperArcTM (HA) is a novel treatment innovation for Stereotactic Radiosurgery (SRS), helpful in improving treatment efficiencies and overall patient experience. MATERIAL AND METHODS This is a retrospective study of 228 patients diagnosed with brain metastases (mets) from solid tumours, who have received SRS at our centre using the HA treatment platform between 2022-2024. The aim of the study was to analyse impact of various clinical factors (primary diagnosis, number of metastases, Planning treatment volume (PTV) and metachronous or synchronous presentation) on overall survival (OS). The OS was calculated from the date of SRS treatment. Statistical analyses were conducted using IBM SPSS Statistics for Windows, version 29.0.2.0. RESULTS The median OS for the entire cohort was 15 months (CI 12.19-17.80). Primary histology has a significant impact on survival with best survival in patient with breast cancer and worst with upper gastrointestinal cancers (22 months vs 3 months respectively) (p=-0.01, log rank test). Number of mets did not significantly affected OS, the median OS was 18 months (CI 0.41-35.58) for ≤5 metastases and 15 months (CI 12.058-17.492) for >5 metastases (p=0.781, log rank test). We also noticed a significant impact of PTV on OS. The median OS was 9 months (CI 5.580-12.420) in patients who had a PTV volume>10cm3 in comparison to 19 months (CI 14.88-23.11) for patients with PTV volume of <10cm3 (p=0.01, log rank test). There was no statistically significant impact of synchronous or metachronous presentation noted on OS. (median OS was 18 months (CI 9.60-26.39) and 15 months (CI 11.73-18.26) respectively (p=0.46, log rank test). CONCLUSION In our experience primary cancer diagnosis significantly affects the OS in the brain metastases patients. Our results also emphasized the importance of careful patient selection and to prioritise smaller volumes than the number of metastasis when treating with SRS.

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