2009
DOI: 10.1016/s1470-2045(09)70263-3
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Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial

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Cited by 2,177 publications
(1,629 citation statements)
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References 28 publications
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“…However with improving targeting technology, stereotactic radiosurgery (SRS) is emerging as an alternative method to treat metastatic disease to the brain. SRS has the advantage of requiring decreased time, increased efficacy against radioresistant tumors, decreased hair loss, and fewer neurocognitive side effects but has the disadvantage of increased likelihood of re-irradiation [19–22]. Currently in the age of new systemic therapies, the role of WBRT and SRS in the treatment of BMs is evolving [23].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…However with improving targeting technology, stereotactic radiosurgery (SRS) is emerging as an alternative method to treat metastatic disease to the brain. SRS has the advantage of requiring decreased time, increased efficacy against radioresistant tumors, decreased hair loss, and fewer neurocognitive side effects but has the disadvantage of increased likelihood of re-irradiation [19–22]. Currently in the age of new systemic therapies, the role of WBRT and SRS in the treatment of BMs is evolving [23].…”
Section: Discussionmentioning
confidence: 99%
“…However Aoyama et al did report an increased incidence of intracranial relapse in patients who received SRS alone [24,25]. A study by Chang et al showed an improved 4-month overall survival in the SRS group and a higher decline in learning and memory in patients treated with both SRS and WBRT, but the local and distant control was better in the SRS plus WBRT group [19]. Nonetheless, it is important to note that Aoyama et al, Sneed et al, and Chang et al looked at BM in general and not BMs from gastrointestinal (GI) primaries.…”
Section: Discussionmentioning
confidence: 99%
“…8 Furthermore, a randomized controlled trial conducted by the MD Anderson Cancer Center assigned cognitive performance as a primary end point. 11 In patients with one to three brain meta stases, a significant difference in memory decline at 4 months after treatment was reported; a larger proportion of patients who received SRS and upfront WBRT (49%) had a memory decline than those who received SRS alone (20%). 11 The protection of organs at risk, such as the hippocampus, temporal lobes and frontal lobes, is one major challenge facing radio-oncologists.…”
Section: Laetitia Padovani Jean Marie Regis and Xavier Muracciolementioning
confidence: 96%
“…11 An indication of the severity of this toxicity was determined using minimental state examination; no significant difference was reported in neurological status between the two arms in the Aoyama study (SRS with or without WBRT). 8 Furthermore, a randomized controlled trial conducted by the MD Anderson Cancer Center assigned cognitive performance as a primary end point.…”
Section: Laetitia Padovani Jean Marie Regis and Xavier Muracciolementioning
confidence: 99%
“…Brain metastases are generally managed with some combination of surgery, whole brain radiotherapy (WBRT), stereotactic radiosurgery, and steroids 2. In a radiotherapy setting, SRS offers durable local control with the possibility of reduced neurocognitive impairment compared to WBRT or a combination of WBRT and SRS 3. However, the use of SRS alone carries an increased risk of distant brain recurrence versus WBRT, which necessitates active monitoring and follow‐up for patients that have been treated with SRS alone (see 2 and Refs.…”
Section: Introductionmentioning
confidence: 99%