Potential Impact of the Interval Between Imaging and Whole-brain Radiotherapy in Patients With Relatively Favorable Survival Prognoses

Hansen, Heinke C.; Thieme, Cathrin; Perlov, Aleksej; Schild, Steven E.; Rades, Dirk

doi:10.21873/anticanres.13247

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Moreover, it investigated pre-treatment seizures to exclude a bias caused by treatment-associated effects. According to previous studies, a bias due to the interval between diagnosis of brain metastases and start of WBI appeared very unlikely (22,23).…”

Section: Discussionmentioning

confidence: 87%

Seizures Prior to Whole-brain Irradiation for Metastatic Disease: Prevalence, Risk Factors and Association With Survival

et al. 2020

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Background/Aim: Seizures are a serious condition for patients with brain metastases. Prevalence, risk factors and a potential association of seizures with survival prior to whole-brain irradiation (WBI) for cerebral metastases were retrospectively investigated. Patients and Methods: In 1,934 patients, the prevalence of pre-treatment seizures (pre-WBI) was determined. Seven pre-treatment characteristics were evaluated for associations with seizures. Ten characteristics including pre-treatment symptoms (none vs. seizures only vs. seizures+others vs. others only) and seizures (yes vs. no) were analyzed for survival. Results: In 251 patients (13.0%), pretreatment seizures were documented. The occurrence of seizures was significantly associated with 1-3 brain metastases and lack of extra-cerebral spread. On multivariate analysis, age, gender, performance score, number of metastases and extra-cerebral spread were significantly associated with survival; pre-treatment symptoms and seizures showed associations on univariate but not on multivariate analyses. Conclusion: Few brain metastases and lack of extra-cerebral spread were independent risk factors for pre-treatment seizures. Seizures appeared positively associated with survival.

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Section: Discussionmentioning

confidence: 87%

Seizures Prior to Whole-brain Irradiation for Metastatic Disease: Prevalence, Risk Factors and Association With Survival

et al. 2020

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“…Considering this very favourable prognosis, patients of this cohort will likely benefit from radiation therapy with 2 Gy ×20, which was reported to achieve significantly increased intracerebral control and overall survival when compared to 3 Gy ×10 (11). Moreover, it has been shown for patients of any age and with various primary tumours, who survived for at least 4 months after radiation therapy, that the interval between the diagnosis of metastatic brain lesions and the start of radiation therapy did not impact the outcomes (12). This finding may be particularly important for older persons, since treatment of their co-morbidities may prolong the time between diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 91%

Individualisation of Radiation Therapy for Older Persons With Secondary Brain Lesions from Carcinoma of the Breast

et al. 2020

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Background/Aim: Outcomes of older persons with secondary brain lesions from carcinoma of the breast may be improved by individualized therapy. This process will likely be easier with survival scores. Patients and Methods: A retrospective study was performed in 111 older patients with carcinoma of the breast irradiated for secondary brain lesions. Dose-fractionation, age, general condition, number of brain lesions, other visceral metastases and time period from breast cancer detection until radiation therapy were investigated. Results: Postradiation survival was significantly related to general condition (p<0.0001) and other visceral metastases (p=0.041). When using these characteristics, sum-scores of 0 (n=46), 1 (n=50) or 2 (n=15) points were gained. 43% and 19% for 1 point, and 73% and 52% for 2 points (p<0.0001). Conclusion: This survival score contributes to treatment individualisation of older patients with secondary brain lesions from carcinoma of the breast.

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European Respiratory Society guideline on various aspects of quality in lung cancer care

Blum

Durieux

Chorostowska‐Wynimko³

et al. 2022

Eur Respir J

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This ERS guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO questions. The evidence was appraised in compliance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multi-disciplinary task force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results.In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) the integration of multi-disciplinary teams and multi-disciplinary consultations, 3) the implementation of and adherence to lung cancer guidelines, 4) the benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) the need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, histological subtyping and the molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) the added value of early integration of palliative care teams or specialists, 7) the advantage of integrating specific quality improvement measures, and 8) the benefit of using patient decision tools.These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available.

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Potential Impact of the Interval Between Imaging and Whole-brain Radiotherapy in Patients With Relatively Favorable Survival Prognoses

Abstract: Background/Aim: The interval between diagnostic imaging and whole-brain radiotherapy (WBRT) had no significant impact on survival in our previous study of WBRT for brain metastases. Since median survival time

Cited by 3 publications

References 14 publications

Seizures Prior to Whole-brain Irradiation for Metastatic Disease: Prevalence, Risk Factors and Association With Survival

Seizures Prior to Whole-brain Irradiation for Metastatic Disease: Prevalence, Risk Factors and Association With Survival

Individualisation of Radiation Therapy for Older Persons With Secondary Brain Lesions from Carcinoma of the Breast

European Respiratory Society guideline on various aspects of quality in lung cancer care

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