Skip to main content

The Role of Whole Brain Radiation Therapy for Metastatic Brain Tumors

  • Chapter
  • First Online:
  • 1340 Accesses

Part of the book series: Tumors of the Central Nervous System ((TCNS,volume 12))

Abstract

Whole brain radiation therapy (WBRT) has long served as an important treatment modality for patients diagnosed with metastatic brain tumors, both alone and in combination with other therapies including surgical resection. The recently published multidisciplinary treatment guideline by Gaspar and Kalkanis for brain metastases evaluates the evidence for the continued use of WBRT, with recommendations for specific clinical scenarios. We will address the subject of the role of WBRT in brain metastases throughout this chapter.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • American Cancer Society (2006) Cancer facts & figures. The Society, Atlanta

    Google Scholar 

  • Ampil FL, Nanda A, Willis BK, Nandy I, Meehan R (1996) Metastatic disease in the cerebellum. The LSU experience in 1981–1993. Am J Clin Oncol 19:509–511

    Article  CAS  PubMed  Google Scholar 

  • Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, Werner-Wasik M, Demas W, Ryu J, Bahary JP, Souhami L, Rotman M, Mehta MP, Curran WJ Jr (2004) Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 363:1665–1672

    Article  PubMed  Google Scholar 

  • Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, Kenjyo M, Oya N, Hirota S, Shioura H, Kunieda E, Inomata T, Hayakawa K, Katoh N, Kobashi G (2006) Stereotactic radiosurgery plus whole-brain radiation therapy vs. stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 295:2483–2491

    Article  CAS  PubMed  Google Scholar 

  • Borgelt B, Gelber R, Kramer S, Brady LW, Chang CH, Davis LW, Perez CA, Hendrickson FR (1980) The palliation of brain metastases: final results of the first two studies by the radiation therapy oncology group. Int J Radiat Oncol Biol Phys 6:1–9

    Article  CAS  PubMed  Google Scholar 

  • Borgelt B, Gelber R, Larson M, Hendrickson F, Griffin T, Roth R (1981) Ultra-rapid high dose irradiation schedules for the palliation of brain metastases: final results of the first two studies by the radiation therapy oncology group. Int J Radiat Oncol Biol Phys 7:1633–1638

    Article  CAS  PubMed  Google Scholar 

  • Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG, Arbuckle RB, Swint JM, Shiu AS, Maor MH, Meyers CA (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol 10:1037–1044

    Article  PubMed  Google Scholar 

  • Chao JH, Phillips R, Nickson JJ (1954) Roentgen-ray therapy of cerebral metastases. Cancer 7:682–689

    Article  CAS  PubMed  Google Scholar 

  • Chatani M, Matayoshi Y, Masaki N, Inoue T (1994) Radiation therapy for brain metastases from lung carcinoma. Prospective randomized trial according to the level of lactate dehydrogenase. Strahlenther Onkol 170:155–161

    CAS  PubMed  Google Scholar 

  • DeAngelis LM, Currie VE, Kim JH, Krol G, O’Hehir MA, Farag FM, Young CW, Posner JB (1989) The combined use of radiation therapy and lonidamine in the treatment of brain metastases. J Neurooncol 7:241–247

    Article  CAS  PubMed  Google Scholar 

  • Eyre HJ, Ohlsen JD, Frank J, LoBuglio AF, McCracken JD, Weatherall TJ, Mansfield CM (1984) Randomized trial of radiotherapy versus radiotherapy plus metronidazole for the treatment metastatic cancer to brain. A southwest oncology group study. J Neurooncol 2:325–330

    Article  CAS  PubMed  Google Scholar 

  • Gaspar LE, Mehta MP, Patchell RA, Burri SH, Robinson PD, Morris RE, Ammirati M, Andrews DW, Asher AL, Cobbs CS, Kondziolka D, Linskey ME, Loeffler JS, McDermott M, Mikkelsen T, Olson JJ, Paleologos NA, Ryken TC, Kalkanis SN (2010) The role of whole brain radiation therapy in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol 96:17–32

    Article  PubMed Central  PubMed  Google Scholar 

  • Gavrilovic IT, Posner JB (2005) Brain metastases: epidemiology and pathophysiology. J Neurooncol 75:5–14

    Article  PubMed  Google Scholar 

  • Harwood AR, Simson WJ (1977) Radiation therapy of cerebral metastases: a randomized prospective clinical trial. Int J Radiat Oncol Biol Phys 2:1091–1094

    Article  CAS  PubMed  Google Scholar 

  • Kalkanis SN, Kondziolka D, Gaspar LE, Burri SH, Asher AL, Cobbs CS, Ammirati M, Robinson PD, Andrews DW, Loeffler JS, McDermott M, Mehta MP, Mikkelsen T, Olson JJ, Paleologos NA, Patchell RA, Ryken TC, Linskey ME (2010) The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol 96:33–43

    Article  PubMed Central  PubMed  Google Scholar 

  • Katz HR (1981) The relative effectiveness of radiation therapy, corticosteroids, and surgery in the management of melanoma metastatic to the central nervous system. Int J Radiat Oncol Biol Phys 7:897–906

    Article  CAS  PubMed  Google Scholar 

  • Kocher M, Soffietti R, Abacioglu U, Villa S, Fauchon F, Baumert BG, Fariselli L, Tzuk-Shina T, Kortmann RD, Carrie C, Ben Hassel M, Kouri M, Valeinis E, van den Berge D, Collette S, Collette L, Mueller RP (2011) Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. J Clin Oncol 29:134–141

    Article  PubMed Central  PubMed  Google Scholar 

  • Komarnicky LT, Phillips TL, Martz K, Asbell S, Isaacson S, Urtasun R (1991) A randomized phase III protocol for the evaluation of misonidazole combined with radiation in the treatment of patients with brain metastases (RTOG-7916). Int J Radiat Oncol Biol Phys 20:53–58

    Article  CAS  PubMed  Google Scholar 

  • Kondziolka D, Patel A, Lunsford LD, Kassam A, Flickinger JC (1999) Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys 45:427–434

    Article  CAS  PubMed  Google Scholar 

  • Li B, Yu J, Suntharalingam M, Kennedy AS, Amin PP, Chen Z, Yin R, Guo S, Han T, Wang Y, Yu N, Song G, Wang L (2000) Comparison of three treatment options for single brain metastasis from lung cancer. Int J Cancer 90:37–45

    Article  CAS  PubMed  Google Scholar 

  • Linskey ME, Kalkanis SN (2010) Evidence-linked, clinical practice guidelines-getting serious; getting professional. J Neurooncol 96:1–5

    Article  PubMed Central  PubMed  Google Scholar 

  • Mehta MP, Rodrigus P, Terhaard CH, Rao A, Suh J, Roa W, Souhami L, Bezjak A, Leibenhaut M, Komaki R, Schultz C, Timmerman R, Curran W, Smith J, Phan SC, Miller RA, Renschler MF (2003) Survival and neurologic outcomes in a randomized trial of motexafin gadolinium and whole-brain radiation therapy in brain metastases. J Clin Oncol 21:2529–2536

    Article  CAS  PubMed  Google Scholar 

  • Mintz AP, Cairncross JG (1998) Treatment of a single brain metastasis: the role of radiation following surgical resection. JAMA 280:1527–1529

    Article  CAS  PubMed  Google Scholar 

  • Nieder C, Berberich W, Schnabel K (1997) Tumor-related prognostic factors for remission of brain metastases after radiotherapy. Int J Radiat Oncol Biol Phys 39:25–30

    Article  CAS  PubMed  Google Scholar 

  • Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, Markesbery WR, Macdonald JS, Young B (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322:494–500

    Article  CAS  PubMed  Google Scholar 

  • Patchell RA, Tibbs PA, Regine WF, Dempsey RJ, Mohiuddin M, Kryscio RJ, Markesbery WR, Foon KA, Young B (1998) Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 280:1485–1489

    Article  CAS  PubMed  Google Scholar 

  • Phillips TL, Scott CB, Leibel SA, Rotman M, Weigensberg IJ (1995) Results of a randomized comparison of radiotherapy and bromodeoxyuridine with radiotherapy alone for brain metastases: report of RTOG trial 89-05. Int J Radiat Oncol Biol Phys 33:339–348

    Article  CAS  PubMed  Google Scholar 

  • Posner JB (1977) Management of central nervous system metastases. Semin Oncol 4:81–91

    CAS  PubMed  Google Scholar 

  • Postmus PE, Haaxma-Reiche H, Smit EF, Groen HJ, Karnicka H, Lewinski T, van Meerbeeck J, Clerico M, Gregor A, Curran D, Sahmoud T, Kirkpatrick A, Giaccone G (2000) Treatment of brain metastases of small-cell lung cancer: comparing teniposide and teniposide with whole-brain radiotherapy–a phase III study of the European organization for the research and treatment of cancer lung cancer cooperative group. J Clin Oncol 18:3400–3408

    CAS  PubMed  Google Scholar 

  • Priestman TJ, Dunn J, Brada M, Rampling R, Baker PG (1996) Final results of the royal college of radiologists’ trial comparing two different radiotherapy schedules in the treatment of cerebral metastases. Clin Oncol (R Coll Radiol) 8:308–315

    Article  CAS  Google Scholar 

  • Sanghavi SN, Miranpuri SS, Chappell R, Buatti JM, Sneed PK, Suh JH, Regine WF, Weltman E, King VJ, Goetsch SJ, Breneman JC, Sperduto PW, Scott C, Mabanta S, Mehta MP (2001) Radiosurgery for patients with brain metastases: a multi-institutional analysis, stratified by the RTOG recursive partitioning analysis method. Int J Radiat Oncol Biol Phys 51:426–434

    Article  CAS  PubMed  Google Scholar 

  • Suh JH, Stea B, Nabid A, Kresl JJ, Fortin A, Mercier JP, Senzer N, Chang EL, Boyd AP, Cagnoni PJ, Shaw E (2006) Phase III study of efaproxiral as an adjunct to whole-brain radiation therapy for brain metastases. J Clin Oncol 24:106–114

    Article  CAS  PubMed  Google Scholar 

  • Sundstrom JT, Minn H, Lertola KK, Nordman E (1998) Prognosis of patients treated for intracranial metastases with whole-brain irradiation. Ann Med 30:296–299

    Article  CAS  PubMed  Google Scholar 

  • Tsao MN, Lloyd N, Wong RK, Chow E, Rakovitch E, Laperriere N, Xu W, Sahgal A (2012) Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases. Cochrane Database Syst Rev 4:CD003869

    PubMed  Google Scholar 

  • Vecht CJ, Haaxma-Reiche H, Noordijk EM, Padberg GW, Voormolen JH, Hoekstra FH, Tans JT, Lambooij N, Metsaars JA, Wattendorff AR et al (1993) Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery? Ann Neurol 33:583–590

    Article  CAS  PubMed  Google Scholar 

  • Voorhies RM, Sundaresan N, Thaler HT (1980) The single supratentorial lesion. An evaluation of preoperative diagnostic tests. J Neurosurg 53:364–368

    Article  CAS  PubMed  Google Scholar 

  • Wang LG, Guo Y, Zhang X, Song SJ, Xia JL, Fan FY, Shi M, Wei LC (2002) Brain metastasis: experience of the Xi-Jing hospital. Stereotact Funct Neurosurg 78:70–83

    Article  PubMed  Google Scholar 

  • Zimm S, Wampler GL, Stablein D, Hazra T, Young HF (1981) Intracerebral metastases in solid-tumor patients: natural history and results of treatment. Cancer 48:384–394

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Steven Kalkanis .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Omodon, M., Kalkanis, S. (2014). The Role of Whole Brain Radiation Therapy for Metastatic Brain Tumors. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 12. Tumors of the Central Nervous System, vol 12. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7217-5_16

Download citation

  • DOI: https://doi.org/10.1007/978-94-007-7217-5_16

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-7216-8

  • Online ISBN: 978-94-007-7217-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics