Early experience and perioperative risk of GammaTile for upfront brain metastases: Report from a prospective multicenter study.

IF 3.7 Q1 CLINICAL NEUROLOGY Neuro-oncology advances Pub Date : 2024-09-10 eCollection Date: 2024-01-01 DOI:10.1093/noajnl/vdae156
Sabrina L Zeller, Sauson Soldozy, Shaye Busse, Clark C Chen, Andrew Venteicher, Clara Ferreira, Kathryn Dusenbery, Stuart Lee, Matthew Sean Peach, Vincent DiNapoli, Rupesh Kotecha, Manmeet S Ahluwalia, Kimberly Bojanowski-Hoang, Simon J Hanft
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Abstract

Background: GammaTile (GT), a form of brachytherapy utilizing cesium-131 seeds in a bioresorbable collagen tile, has gained popularity for the treatment of recurrent intracranial tumors and more recently for newly diagnosed metastases. This study reports early experience utilizing GT in upfront brain metastases with a focus on clinical applications and perioperative safety.

Methods: The STaRT Registry (NCT04427384) was queried for all patients receiving GT for upfront metastases from August 2021 to August 2023. Data regarding patient demographics, procedure details, and adverse events (AEs) were extracted and analyzed.

Results: Twenty-eight patients, median age 65 years (range 28-81), with 30 treated metastases were reported from 6 institutions. Patients had 2.8 metastases on average (range 1-15) at the time of surgery; however, most patients had a single metastasis (60.7%). The mean diameter of treated metastases was 3.4 cm (range 1.5-4.7). A median of 4.0 tiles (range 1-10) were used per tumor. The median follow-up was 3.0 months (range 1.0-11.2) with 6 attributed AEs (21.4%), including 1 grade ≥ 3 (infection). In the immediate postoperative period (<14 days), 2 patients reported pain or headache, and 1 reported facial edema. One patient developed seizures on postoperative day 8 requiring medication. At 1-month follow-up, there was 1 superficial wound infection, in a previously colonized patient, requiring surgical intervention without explantation of tiles. At 3-month follow-up, 1 patient reported facial pain not requiring treatment. There were no symptomatic hematomas.

Conclusions: GT demonstrates a favorable safety profile in upfront brain metastases with a 3.6% rate of serious AEs (grade ≥ 3) within 90 days of the procedure.

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GammaTile治疗前期脑转移瘤的早期经验和围手术期风险:一项前瞻性多中心研究的报告。
背景:伽马磁砖(GT)是一种近距离放射疗法,利用生物可吸收胶原磁砖中的铯-131种子治疗复发性颅内肿瘤,最近又用于治疗新诊断的转移瘤。本研究报告了利用 GT 治疗前沿脑转移瘤的早期经验,重点关注临床应用和围手术期的安全性:方法:查询 STaRT 注册表(NCT04427384),了解 2021 年 8 月至 2023 年 8 月期间所有接受 GT 治疗前沿转移瘤的患者。提取并分析了有关患者人口统计学、手术细节和不良事件(AEs)的数据:来自 6 家机构的 28 名患者接受了治疗,中位年龄为 65 岁(28-81 岁),有 30 个转移灶。手术时,患者平均有 2.8 个转移灶(1-15 个不等);但大多数患者只有一个转移灶(60.7%)。转移瘤的平均直径为 3.4 厘米(1.5-4.7 厘米不等)。每个肿瘤使用的瓷砖中位数为 4.0 个(1-10 个不等)。中位随访时间为 3.0 个月(1.0-11.2 个月),共发生 6 起归因性 AE(21.4%),其中 1 起等级≥ 3(感染)。在术后初期(结论:GT 在术后 3 个月内显示出良好的安全性:GT对前期脑转移具有良好的安全性,术后90天内严重AEs(≥3级)发生率为3.6%。
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CiteScore
6.20
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审稿时长
12 weeks
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