Dataset Information

Radiomics-based prediction of local control in patients with brain metastases following postoperative stereotactic radiotherapy.

ABSTRACT:

Background

Surgical resection is the standard of care for patients with large or symptomatic brain metastases (BMs). Despite improved local control after adjuvant stereotactic radiotherapy, the risk of local failure (LF) persists. Therefore, we aimed to develop and externally validate a pre-therapeutic radiomics-based prediction tool to identify patients at high LF risk.

Methods

Data were collected from A Multicenter Analysis of Stereotactic Radiotherapy to the Resection Cavity of BMs (AURORA) retrospective study (training cohort: 253 patients from 2 centers; external test cohort: 99 patients from 5 centers). Radiomic features were extracted from the contrast-enhancing BM (T1-CE MRI sequence) and the surrounding edema (T2-FLAIR sequence). Different combinations of radiomic and clinical features were compared. The final models were trained on the entire training cohort with the best parameter set previously determined by internal 5-fold cross-validation and tested on the external test set.

Results

The best performance in the external test was achieved by an elastic net regression model trained with a combination of radiomic and clinical features with a concordance index (CI) of 0.77, outperforming any clinical model (best CI: 0.70). The model effectively stratified patients by LF risk in a Kaplan-Meier analysis (P < .001) and demonstrated an incremental net clinical benefit. At 24 months, we found LF in 9% and 74% of the low and high-risk groups, respectively.

Conclusions

A combination of clinical and radiomic features predicted freedom from LF better than any clinical feature set alone. Patients at high risk for LF may benefit from stricter follow-up routines or intensified therapy.

SUBMITTER: Buchner JA

PROVIDER: S-EPMC11376458 | biostudies-literature | 2024 Sep

REPOSITORIES: biostudies-literature

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Publications

Radiomics-based prediction of local control in patients with brain metastases following postoperative stereotactic radiotherapy.

Buchner Josef A JA Kofler Florian F Mayinger Michael M Christ Sebastian M SM Brunner Thomas B TB Wittig Andrea A Menze Bjoern B Zimmer Claus C Meyer Bernhard B Guckenberger Matthias M Andratschke Nicolaus N El Shafie Rami A RA Debus Jürgen J Rogers Susanne S Riesterer Oliver O Schulze Katrin K Feldmann Horst J HJ Blanck Oliver O Zamboglou Constantinos C Ferentinos Konstantinos K Bilger-Zähringer Angelika A Grosu Anca L AL Wolff Robert R Piraud Marie M Eitz Kerstin A KA Combs Stephanie E SE Bernhardt Denise D Rueckert Daniel D Wiestler Benedikt B Peeken Jan C JC

Neuro-oncology 20240901 9

<h4>Background</h4>Surgical resection is the standard of care for patients with large or symptomatic brain metastases (BMs). Despite improved local control after adjuvant stereotactic radiotherapy, the risk of local failure (LF) persists. Therefore, we aimed to develop and externally validate a pre-therapeutic radiomics-based prediction tool to identify patients at high LF risk.<h4>Methods</h4>Data were collected from A Multicenter Analysis of Stereotactic Radiotherapy to the Resection Cavity of ...[more]

PMID: 38813990

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Project description:PurposeWe aimed to retrospectively assess the incidence of vertebral compression fractures (VCF), examine clinicopathologic factors potentially associated with VCF, and evaluate treatment response in patients who received stereotactic body radiotherapy (SBRT) for spine metastases (spMets).Methods and materialsWe identified 78 patients with 125 spMets at baseline and subsequent assessments. Patients received SBRT doses of 16 or 18 Gy. Patients with pre-existing VCF and co-existing local progression were excluded. Spine instability neoplastic score (SINS) was used for spMets categorization. Response to SBRT and VCF were assessed according to the Positron Emission tomography Response Criteria In Solid Tumors (PERCIST) and Genant scores, respectively. Kaplan-Meier analyses were used to assess local control of disease and vertebral compression fracture-free survival (FFS).ResultsWe treated 103 cases with single spMets and 11 cases involving double spMets with SBRT. Progressive disease was reported in 3.2% and 8.2% of the cases in the first and last PET/CT reports, respectively. The distribution of treatment response in the remaining patients was: complete response in 30.6% of patients, partial response in 47.1% of patients, and stable disease in 22.3% of patients in the first PET/CT; complete response in 62.3% of patients, partial response in 16.7% of patients, and stable disease in 21% of patients at the last monitoring. Local failures were observed in 15 (12%) of cases. Median SINS was 5 (range: 1-13); majority of patients in our cohort (70.4%) were categorized as stable according to SINS, five (4%) patients had Grade 3 VCF at a median time of 16 months after SBRT (range: 2-22 months), and 60% of VCF occurred after an interval of at least 12 months after SBRT. No bisphosphonate usage was significantly associated with VCF (r = -0.204; p = 0.022). Median FFS was 21 months. Univariate analyses indicated that female gender (p < 0.001), bisphosphonate use (p = 0.005), >6 months of bisphosphonates use (p = 0.002), and the lowest vertebral body collapse score (p = 0.023) were associated with higher FFS. Female gender (p = 0.007), >6 months of bisphosphonates usage (p = 0.018), and the lowest vertebral body collapse score (p = 0.044) retained independent significance.ConclusionsThis study demonstrated that spine SBRT with doses of 16-18 Gy promises good local control of disease with acceptable VCF rates. Lowest vertebral body collapse score, female gender, and >6 months of bisphosphonate use were significantly associated with longer FFS.

Dataset Information

Radiomics-based prediction of local control in patients with brain metastases following postoperative stereotactic radiotherapy.

Background

Methods

Results

Conclusions

Publications

Radiomics-based prediction of local control in patients with brain metastases following postoperative stereotactic radiotherapy.

Similar Datasets

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