The role of whole brain radiation therapy in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline.

Journal of Neuro-oncology
Laurie E GasparSteven N Kalkanis

Abstract

Should patients with newly-diagnosed metastatic brain tumors undergo open surgical resection versus whole brain radiation therapy (WBRT) and/or other treatment modalities such as radiosurgery, and in what clinical settings? These recommendations apply to adults with a newly diagnosed single brain metastasis amenable to surgical resection. Surgical resection plus WBRT versus surgical resection alone Level 1 Surgical resection followed by WBRT represents a superior treatment modality, in terms of improving tumor control at the original site of the metastasis and in the brain overall, when compared to surgical resection alone. Surgical resection plus WBRT versus SRS + or - WBRT Level 2 Surgical resection plus WBRT, versus stereotactic radiosurgery (SRS) plus WBRT, both represent effective treatment strategies, resulting in relatively equal survival rates. SRS has not been assessed from an evidence-based standpoint for larger lesions (>3 cm) or for those causing significant mass effect (>1 cm midline shift). Level 3 Underpowered class I evidence along with the preponderance of conflicting class II evidence suggests that SRS alone may provide equivalent functional and survival outcomes compared with resection + WBRT for patients wit...Continue Reading

References

Feb 22, 1990·The New England Journal of Medicine·R A PatchellB Young
Jul 1, 1985·Acta Radiologica. Oncology·M ChataniT Suzuki
Jul 1, 1981·International Journal of Radiation Oncology, Biology, Physics·J M KurtzJ S Cooper
Sep 30, 1995·International Journal of Radiation Oncology, Biology, Physics·C NiederK Schnabel
Feb 1, 1993·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·C Haie-MederR Arriagada
Jul 1, 1994·International Journal of Radiation Oncology, Biology, Physics·E M NoordijkA R Wattendorff
Jul 15, 1993·International Journal of Radiation Oncology, Biology, Physics·W T SauseH Selim
Jun 1, 1993·Annals of Neurology·C J VechtA R Wattendorff
Oct 1, 1996·American Journal of Clinical Oncology·F L AmpilR Meehan
Sep 1, 1996·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·F BachS A Engelholm
Jan 1, 1996·Clinical Oncology : a Journal of the Royal College of Radiologists·T J PriestmanP G Baker
Nov 19, 1997·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·C NiederK Schnabel
May 2, 2006·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·Carlos ConillTeresa Castel
Aug 11, 2007·International Journal of Radiation Oncology, Biology, Physics·Dirk RadesSteven E Schild
Oct 26, 2007·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Dirk RadesJuergen Dunst
Jan 12, 2008·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Dirk RadesJochen Dahm-Daphi
Apr 1, 2008·International Journal of Radiation Oncology, Biology, Physics·Dirk RadesSteven E Schild
Jun 17, 2008·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Phillip DaveyJennifer Smith
Oct 23, 2009·British Journal of Sports Medicine·Catherine SherringtonChristopher G Maher
Feb 23, 2010·Journal of Clinical Epidemiology·Luciana Gazzi MacedoCatherine Sherrington

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Citations

Oct 15, 2011·The New England Journal of Medicine·Michael LanutiMari Mino-Kenudson
Nov 20, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·S PetersUNKNOWN ESMO Guidelines Working Group
Oct 3, 2013·Neuro-oncology·Anna S BerghoffMatthias Preusser
Jan 24, 2013·International Journal of Molecular Sciences·Torill E SjøbakkTone F Bathen
Dec 18, 2013·Clinical Oncology : a Journal of the Royal College of Radiologists·T MuraiY Shibamoto
Nov 22, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Zhengbo Song, Yiping Zhang
Jun 24, 2014·Clinical Lung Cancer·David E DawePeter M Ellis
Mar 13, 2014·International Journal of Radiation Oncology, Biology, Physics·Anthony L AsherRobert W Fraser
Nov 7, 2013·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·X JiangL Liu
Apr 26, 2014·Journal of Cancer Research and Therapeutics·Alessandro AgnolettiDiego Garbossa
Apr 22, 2014·Clinical Oncology : a Journal of the Royal College of Radiologists·B JeremicL Fourie
Jan 15, 2015·CNS Oncology·F BertoliniG Luppi
Sep 14, 2011·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Xiao-Bing JiangYong-Gao Mou
Mar 24, 2012·Journal of Cancer Research and Clinical Oncology·Hiroshi MayaharaJun Itami
Feb 18, 2016·Breast Cancer : the Journal of the Japanese Breast Cancer Society·Chikako YamauchiHirofumi Mukai
May 13, 2014·International Journal of Molecular Sciences·Agnes V TalletPhilippe Metellus
Jan 28, 2016·Clinical Neurology and Neurosurgery·Angelika BilgerAnca-Ligia Grosu
May 2, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·David F SlottjeRicardo J Komotar
Feb 26, 2013·World Neurosurgery·Zhengbo SongYiping Zhang
Nov 13, 2012·Biochimica Et Biophysica Acta·Emmanouil FokasClaus Rödel
Sep 19, 2012·Seminars in Radiation Oncology·George Rodrigues, Michael Sanatani
Jul 13, 2012·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·A L BracciniA Tallet
Aug 14, 2012·International Journal of Radiation Oncology, Biology, Physics·Julius O EbinuGelareh Zadeh
May 26, 2012·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·G NoëlF Thillays
Jun 15, 2011·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·A NiwińskaP Niwiński
Jul 20, 2011·Cancer Treatment Reviews·Jordi RemonSusana Martínez
Jan 5, 2011·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Michael D JenkinsonMohsen Javadpour
Nov 27, 2010·Neurosurgery Clinics of North America·Nicholas Butowski
Nov 27, 2010·Neurosurgery Clinics of North America·Anthony L D'AmbrosioSteven R Isaacson
Nov 27, 2010·Neurosurgery Clinics of North America·Roukoz B Chamoun, Franco DeMonte
Nov 27, 2010·Neurosurgery Clinics of North America·Muhammad M Abd-El-BarrGanesh Rao

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Methods Mentioned

BETA
surgical resection
Surgical
biopsy

Clinical Trials Mentioned

NCT00138788

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