The RSSearch™ Registry: patterns of care and outcomes research on patients treated with stereotactic radiosurgery and stereotactic body radiotherapyReport as inadecuate




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Radiation Oncology

, 8:275

Clinical Radiation Oncology

Abstract

BackgroundThe RSSearch™ Registry is a multi-institutional, observational, ongoing registry established to standardize data collection from patients treated with stereotactic radiosurgery SRS and-or stereotactic body radiotherapy SBRT. This report describes the design, patient demographics, lesion characteristics, and SRS-SBRT treatment patterns in RSSearch™. Illustrative patient-related outcomes are also presented for two common treatment sites – brain metastases and liver metastases.

Materials and methodsThirty-nine US centers participated in RSSearch™. Patients screened for SRS-SBRT were eligible to be enrolled. Descriptive analyses were performed to assess patient characteristics, physician treatment practices, and clinical outcomes. Kaplan-Meier analysis was used to determine overall survival OS, local progression-free LPFS, and distant disease-free survival DDFS.

ResultsFrom January, 2008 – January, 2013, 11,457 patients were enrolled. The median age was 67 years range 7–100 years; 51% male and 49% female. Forty-six percent had no prior treatment, 22% had received chemotherapy, 19% radiation therapy and 17% surgery. There were 11,820 lesions from 65 treatment locations; 54% extracranial and 46% intracranial. The most common treatment locations were brain-cranial nerve-spinal cord, lung, prostate and liver. Metastatic lesions accounted for the majority of cases 41.6%, followed by primary malignant 32.9%, benign 10.9%, recurrent 9.4%, and functional diseases 4.3%. SRS-SBRT was used with a curative intent in 39.8% and palliative care in 44.8% of cases. The median dose for all lesions was 30 Gy range < 1 – 96.7 Gy delivered in a median number of 3 fractions. The median dose for lesions in the brain-cranial nerve-spinal cord, lung, liver, pancreas and prostate was 24, 54, 45, 29 and 36.25 Gy, respectively. In a subset analysis of 799 patients with 952 brain metastases, median OS was 8 months. For patients with a Karnofsky performance score KPS > 70, OS was 11 months vs. 4 months for KPS ≤ 70. Six-month and 12-month local control was 79% and 61%, respectively for patients with KPS ≤ 70, and 85% and 74%, respectively for patients with KPS > 70. In a second subset analysis including 174 patients with 204 liver metastases, median OS was 22 months. At 1-year, LPFS and DDFS rates were 74% and 53%, respectively. LPFS.

ConclusionThis study demonstrates that collective patterns of care and outcomes research for SRS-SBRT can be performed and reported from data entered by users in a common database. The RSSearch™ dataset represents SRS-SBRT practices in a real world setting, providing a useful resource for expanding knowledge of SRS-SBRT treatment patterns and outcomes and generating robust hypotheses for randomzed clinical studies.

KeywordsStereotactic radiosurgery Stereotactic body radiation therapy Registry Brain metastases Lung cancer Liver metastases Prostate cancer Pancreatic cancer Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-8-275 contains supplementary material, which is available to authorized users.

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Author: Joanne N Davis - Clinton Medbery III - Sanjeev Sharma - Adnan Danish - Anand Mahadevan

Source: https://link.springer.com/







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