Whole-Brain Radiotherapy for Brain Metastases: Evolution or Revolution?

Brown, Paul D.; Ahluwalia, Manmeet; Khan, Osaama H.; Asher, Anthony L.; Wefel, Jeffrey S.; Gondi, Vinai

doi:10.1200/jco.2017.75.9589

Cited by 184 publications

(130 citation statements)

References 64 publications

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“…Whole-brain radiotherapy (WBRT) in comparison to stereotactic radiotherapy is not associated with improved survival in patients with a limited number of BMs but is associated with negative neurocognitive effects [16e18]. As a consequence, stereotactic radiotherapy without WBRT for patients with a limited number of BMs, mostly defined as up to four lesions, is currently the preferred treatment strategy [19,20]. However, in our data set, the majority of patients received WBRT.…”

Section: Discussionmentioning

confidence: 92%

Treatment and outcomes of patients in the Brain Metastases in Breast Cancer Network Registry

Witzel

Laakmann

Weide³

et al. 2018

European Journal of Cancer

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Section: Discussionmentioning

confidence: 92%

Treatment and outcomes of patients in the Brain Metastases in Breast Cancer Network Registry

Witzel

Laakmann

Weide³

et al. 2018

European Journal of Cancer

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“…Traditionally, most patients with BM have been treated with whole brain radiation therapy (WBRT) [3,8,9]. However, due to advances in the technology, and the increased availability, of stereotactic radiosurgery (SRS) and concerns about the long-term side effects of WBRT, radiation treatment is shifting toward SRS [3,[10][11][12]. The high precision of SRS spares healthy brain tissue, reducing the risks of long-term side effects [13,14].…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in adult patients with brain metastases after stereotactic radiosurgery: a systematic, narrative review

Verhaak

Gehring

Hanssens

et al. 2019

Support Care Cancer

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Purpose A growing number of patients with brain metastases (BM) are being treated with stereotactic radiosurgery (SRS), and the importance of evaluating the impact of SRS on the health-related quality of life (HRQoL) in these patients has been increasingly acknowledged. This systematic review summarizes the current knowledge about the HRQoL of patients with BM after SRS. Methods We searched EMBASE, Medline Ovid, Web-of-Science, the Cochrane Database, PsycINFO Ovid, and Google Scholar up to November 15, 2018. Studies in patients with BM in which HRQoL was assessed before and after SRS and analyzed over time were included. Studies including populations of several types of brain cancer and/or several types of treatments were included if the results for patients with BM and treatment with SRS alone were described separately. Results Out of 3638 published articles, 9 studies met the eligibility criteria and were included. In 4 out of 7 studies on group results, overall HRQoL of patients with BM remained stable after SRS. In small study samples of longer-term survivors, overall HRQoL remained stable up to 12 months post-SRS. Contradictory results were reported for physical and general/global HRQoL, which might be explained by the different questionnaires that were used. Conclusions In general, SRS does not have significant negative effects on patients' overall HRQoL over time. Future research is needed to analyze different aspects of HRQoL, differences in individual changes in HRQoL after SRS, and factors that influence these changes. These studies should take into account several methodological issues as discussed in this review.

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“…WBRT has been the most common treatment modality for BM. Although the benefit of SRS for patients with a limited number of BM has been emphasized 14,15 , WBRT still has an important role in the treatment of patients unsuitable for SRS or surgery, in the management of multiple BM 16 , and as adjuvant treatment after SRS or surgery 13,17 .…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for survival in colorectal cancer patients with brain metastases undergoing whole brain radiotherapy: multicenter retrospective study

Koo

Kim

Park

et al. 2020

Sci Rep

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Whole brain radiotherapy (WBRt) is a mainstay of the treatment for brain metastases (BM). We evaluated prognostic factors in colorectal cancer (cRc) patients undergoing WBRt for BM. the medical records of 106 CRC patients undergoing WBRT for BM between 2000 and 2014 at three institutions were reviewed. patient and tumor factors were analyzed to identify the prognostic factors for overall survival (oS) calculated from the date of BM diagnosis to the date of death or last follow-up. Surgical resection of BM was performed in six patients. The dose of WBRT was 30 Gy, and boost radiotherapy or stereotactic radiosurgery (8-23 Gy) was given to 15 patients. Systemic therapy for BM was administered in one patient before WBRT and 26 patients after WBRT. The median follow-up time was 3.9 months (range, 0.4-114.1 months). The median OS time was 3.9 months, and the 1-year OS rate was 18.2%. older age (>65 years), multiple BM (≥3), elevated level of carcinoembryonic antigen (CEA, >5 ng/ml) at BM diagnosis, and extracranial metastases were adverse prognostic factors for OS. Patient with 0-1 factor showed better OS (at 1 year, 76.9%) than patients with 2 factors (16.7%) or 3-4 factors (4.2%; p < 0.001). In conclusion, we evaluated age, the number of BM, CEA level, and extracranial metastases as the prognostic factors for oS in cRc patients undergoing WBRt. our result might be useful to develop prognostic models predicting survival for patients whom WBRt is intended for.

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Whole-Brain Radiotherapy for Brain Metastases: Evolution or Revolution?

Cited by 184 publications

References 64 publications

Treatment and outcomes of patients in the Brain Metastases in Breast Cancer Network Registry

Treatment and outcomes of patients in the Brain Metastases in Breast Cancer Network Registry

Health-related quality of life in adult patients with brain metastases after stereotactic radiosurgery: a systematic, narrative review

Prognostic factors for survival in colorectal cancer patients with brain metastases undergoing whole brain radiotherapy: multicenter retrospective study

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