1159 / 1578
/
Ø
Highly favorable failure pattern
Ø
Promising OS (in highly selected patients)
Prospective Phase II trial:
24 patients with 52 sites
•
Maximum 5 Platin-resistant sites based on FDG-PET
•
SBRT to all progressive sites,
•
Switch to concurrent Erlotinib
In-field failure
3 / 21
Out-field failure
10 / 21
No failure
10 / 21
Oligo-progression:
SBRT & switch to next line systemic Tx
Iyenger JCO 2014
PFS median 15 mo
07.09.17
ESTRO SBRT COURSE 2017 - Matthias Guckenberger
15
/
Brain mets in patients with driver mutations
Ø
Safe concept to delay local RT / SRS ?
07.09.17
ESTRO SBRT COURSE 2017 - Matthias Guckenberger
16
Cancer with available effective systemic Tx
e.g. activating driver mutation
Development of brain metastases
Small asymptomatic
Large symptomatic
Systemic treatment
Local treatment