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.
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American Cancer Society (2006) Cancer facts & figures. The Society, Atlanta
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
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
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
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
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
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
Chao JH, Phillips R, Nickson JJ (1954) Roentgen-ray therapy of cerebral metastases. Cancer 7:682–689
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
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
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
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
Gavrilovic IT, Posner JB (2005) Brain metastases: epidemiology and pathophysiology. J Neurooncol 75:5–14
Harwood AR, Simson WJ (1977) Radiation therapy of cerebral metastases: a randomized prospective clinical trial. Int J Radiat Oncol Biol Phys 2:1091–1094
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
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
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
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
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
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
Linskey ME, Kalkanis SN (2010) Evidence-linked, clinical practice guidelines-getting serious; getting professional. J Neurooncol 96:1–5
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
Mintz AP, Cairncross JG (1998) Treatment of a single brain metastasis: the role of radiation following surgical resection. JAMA 280:1527–1529
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
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
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
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
Posner JB (1977) Management of central nervous system metastases. Semin Oncol 4:81–91
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
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
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
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
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
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
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
Voorhies RM, Sundaresan N, Thaler HT (1980) The single supratentorial lesion. An evaluation of preoperative diagnostic tests. J Neurosurg 53:364–368
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
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
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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
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