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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Benchmarking of safety indicators for surgical treatment of brain metastases combined with intraoperative radiotherapy – Results of a prospective observational study with comparative matched-pair analysis

Safety-Analyse der intraoperativen Bestrahlung in der Hirnmetastasenchirurgie: Die Ergebnisse einer prospektiven Beobachtungsstudie und Matched-Pair-Analyse

Meeting Abstract

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  • presenting/speaker Anna-Laura Potthoff - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Motaz Hamed - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Julian P. Layer - Universitätsklinikum Bonn, Department of Radiation Oncology, Bonn, Deutschland
  • David Koch - Universitätsklinikum Bonn, Department of Radiation Oncology, Bonn, Deutschland
  • Valeri Borger - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Muriel Heimann - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Davide Scafa - Universitätsklinikum Bonn, Department of Radiation Oncology, Bonn, Deutschland
  • Gustavo R. Sarria - Universitätsklinikum Bonn, Department of Radiation Oncology, Bonn, Deutschland
  • Jasmin A. Holz - Universitätsklinikum Bonn, Department of Radiation Oncology, Bonn, Deutschland
  • Frederic Carsten Schmeel - Universitätsklinikum Bonn, Klinik für Neuroradiologie, Bonn, Deutschland
  • Alexander Radbruch - Universitätsklinikum Bonn, Klinik für Neuroradiologie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Niklas Schäfer - Universitätsklinikum Bonn, Division of Clinical Neuro-Oncology, Department of Neurology, Bonn, Deutschland
  • Patrick Schuss - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Stephan Garbe - Universitätsklinikum Bonn, Department of Radiation Oncology, Bonn, Deutschland
  • Frank A. Giordano - Universitätsklinikum Bonn, Department of Radiation Oncology, Bonn, Deutschland
  • Ulrich Herrlinger - Universitätsklinikum Bonn, Division of Clinical Neuro-Oncology, Department of Neurology, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Leonard Christopher Schmeel - Universitätsklinikum Bonn, Department of Radiation Oncology, Bonn, Deutschland
  • Matthias Schneider - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV169

doi: 10.3205/22dgnc165, urn:nbn:de:0183-22dgnc1657

Published: May 25, 2022

© 2022 Potthoff et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Intraoperative radiotherapy (IORT) of the operative cavity for surgically treated brain metastases (BM) has gained increasing prominence with respect to improved local tumor control. However, IORT performed immediately at the time of surgery might be associated with increased levels of perioperative adverse events (PAE). In the present study the authors performed safety metric profiling in patients that had undergone surgery for BM with and without IORT in order to comparatively analyze feasibility of IORT as an adjuvant radiation approach.

Methods: Between November 2020 and October 2021, 35 patients were surgically treated for BM with IORT at the authors’ neuro-oncological center. Perioperative complication profiles were collected in a prospective observational cohort study by means of patient safety indicators (PSIs), hospital-acquired conditions (HACs), and specific cranial surgery-related complications (CSCs) as high standard quality metric tools and compared to an institutional cohort of 388 patients with BM resection without IORT in a balanced comparative matched-pair analysis.

Results: Overall, 4 out of 35 patients (11%) with IORT in the course BM resection suffered from PAEs accounting for 3 PSIs (9%) and 1 HAC (3%). Balanced matched pair analysis did not reveal significant differences in perioperative complication profiles between the cohorts of patients with and without IORT (p=0.44). 30 day mortality rates were 6% for patients with IORT versus 8% for patients without IORT (p=0.73).

Conclusion: The present study indicates IORT to constitute a safe and clinically-feasible adjuvant treatment modality in patients undergoing surgical resection of BM.