Current Oncology Reports

, Volume 13, Issue 4, pp 255–258 | Cite as

Adjuvant Whole-Brain Radiotherapy Versus Observation after Radiosurgery or Surgical Resection of One to Three Cerebral Metastases: Results of the EORTC 22952-26001 Study

  • Tarek Mekhail
  • Michael Sombeck
  • Robert Sollaccio
Clinical Trial Report

Kocher M, Soffietti R, Abacioglu U, et al.: 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 2011, 29:134–141.

Rating •Of importance.

Introduction: Brain metastases are a frequent cause of morbidity and mortality in patients suffering from a variety of solid tumors. Surgery, radiosurgery, and whole-brain radiotherapy (WBRT) are the main treatment options. The role of adjuvant WBRT after complete surgical resection or radiosurgery remains controversial. The risk of long-term neurotoxicity and availability of effective salvage treatments [1, 2] are the main arguments against adjuvant WBRT.

Aim: The objective of this study was to investigate the role of adjuvant WBRT after either surgery or radiosurgery of a limited number of brain metastases from solid tumors, focusing on patients in good condition with stable systemic cancer.

Methods:Patients with one...


Brain Metastasis Functional Independence Macroscopic Tumor Neurologic Death Curative Intent Treatment 
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  1. 1.
    Sneed PK, Lamborn KR, Forstner JM, McDermott MW, et al. Radiosurgery for brain metastases: Is whole brain irradiation necessary? Int J Radiat Oncol Biol Phys. 1999;43:549–58.PubMedCrossRefGoogle Scholar
  2. 2.
    Sneed PK, Suh JH, Goetsch SJ, Sanghavi SN, et al. A multi-institutional review of radiosurgery alone vs. radiosurgery with whole brain radiotherapy as the initial management of brain metastases. Int J Radiat Oncol Biol Phys. 2002;53:519–26.PubMedCrossRefGoogle Scholar
  3. 3.
    Bartelink H, Overgaard J. Special issue: Late Effects of Normal Tissues (LENT) consensus conference. Radiother Oncol. 1995;35:1–60.PubMedCrossRefGoogle Scholar
  4. 4.
    Rubin P, Constine LS, Fajardo LF, Phillips TL, et al. Overview: Late Effects of Normal Tissues (LENT) scoring system. Int J Radiat Oncol Biol Phys. 1995;31(5):1041–2.PubMedCrossRefGoogle Scholar
  5. 5.
    Patchell RA. The management of brain metastases. Cancer Treat Rev. 2003;29:533–40.PubMedCrossRefGoogle Scholar
  6. 6.
    Bradley KA, Mehta MP. Management of brain metastases. Semin Oncol. 2004;31:693–701.PubMedCrossRefGoogle Scholar
  7. 7.
    Fuller BG, Kaplan ID, Adler J, Cox RS, et al. Stereotactic radiosurgery for brain metastases: The importance of adjuvant whole brain irradiation. Int J Radiat Oncol Biol Phys. 1992;23:413–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Pirzkall A, Debus J, Lohr F, Fuss M, et al. Radiosurgery alone or in combination with whole-brain radiotherapy for brain metastases. J Clin Oncol. 1998;16:3563–9.PubMedGoogle Scholar
  9. 9.
    Chidel MA, Suh JH, Reddy CA, Chaos ST, et al. Application of recursive partitioning analysis and evaluation of the use of whole brain radiation among patients treated with stereotactic radiosurgery for newly diagnosed brain metastases. Int J Radiat Oncol Biol Phys. 2000;47:993–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Shehata MK, Young B, Reid B, Patchell RA, et al. Stereotactic radiosurgery of 468 brain metastases < or = 2 cm: Implications for SRS dose and whole brain radiotherapy. Int J Radiat Oncol Biol Phys. 2004;59:87–93.PubMedCrossRefGoogle Scholar
  11. 11.
    Patchell RA, Tibbs PA, Regine WF, Dempsey RJ, et al. Postoperative radiotherapy in the treatment of single metastases to the brain: A randomized trial. JAMA. 1998;280:1485–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Aoyama H, Shirato H, Tago M, Nakagawa K, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: A randomized controlled trial. JAMA. 2006;295:2483–91.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Tarek Mekhail
    • 1
  • Michael Sombeck
    • 1
  • Robert Sollaccio
    • 1
  1. 1.Florida Hospital Cancer InstituteOrlandoUSA

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