To assess the impact of perilesional edema volume (PEV) on intracranial response and survival in patients with melanoma brain metastases treated with stereotactic radiotherapy (SRT) and various systemic therapies, including immunotherapy and targeted therapy.
Key Findings:
Larger PEV volumes are associated with a higher risk of intracranial progression, indicating a need for careful monitoring.
A PEV cut-off of 0.5 cc significantly predicts local intracranial progression-free survival (L-iPFS), suggesting its utility in treatment planning.
The study found a correlation between PEV and overall survival (OS) in patients treated with SRT, highlighting its potential as a prognostic marker.
Interpretation:
PEV may serve as a valuable predictive factor for treatment response and survival outcomes in melanoma brain metastases, emphasizing its potential role in clinical decision-making and personalized treatment strategies.
Limitations:
Retrospective design may introduce biases that could affect the reliability of the findings.
Limited sample size may affect generalizability to the broader population of melanoma patients.
Exclusion of patients with prior treatments may limit applicability to those with more complex treatment histories.
Conclusion:
PEV is a significant predictor of response to SRT in melanoma brain metastases, suggesting that it should be considered in treatment planning and prognostication, and further research is warranted to explore its role in clinical practice.
by Mariya Yavorska, Miriam Tomaciello, Antonio Sciurti, Elisa Cinelli, Giovanni Rubino, Armando Perrella, Alfonso Cerase, Pierpaolo Pastina, Giovanni Luca Gravina, Silvia Arcieri, Maria Antonietta Mazzei, Giuseppe Migliara, Valentina Baccolini, Francesco Marampon, Giuseppe Minniti, Anna Maria Di Giacomo, Paolo Tini
