Adjuvant whole brain radiotherapy: Strong emotions decide but rational studies are needed

被引:39
作者
Brown, Paul D. [1 ]
Asher, Anthony L. [2 ,3 ,5 ]
Farace, Elana [4 ,5 ]
机构
[1] Mayo Clin, Dept Radiat Oncol, Rochester, MN USA
[2] Carolinas Med Ctr, Brain Tumors Program, Charlotte, NC 28203 USA
[3] Presbyterian Hosp, Charlotte, NC USA
[4] Penn State Univ, Milton S Hershey Med Ctr, Dept Neurosurg, Hershey, PA 17033 USA
[5] Carolinas Med Ctr, Spinal Cord Tumors Program, Charlotte, NC 28203 USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2008年 / 70卷 / 05期
关键词
brain metastases; radiosurgery; whole brain radiotherapy; quality of life; neurocognitive;
D O I
10.1016/j.ijrobp.2007.11.047
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Brain metastases are common in cancer patients and cause considerable morbidity and mortality. For patients with limited disease and good performance status, treatment typically involves a combination of focal measures (e.g., surgical resection or radiosurgery) for the radiographically apparent disease, followed by adjuvant whole brain radiotherapy (WBRT) to treat subclinical disease. Because of concerns regarding the toxicity of WBRT, especially neurocognitive deterioration, many have advocated withholding adjuvant WBRT. Recently published studies have shed more light on the efficacy of adjuvant WBRT and the neurocognitive effects of WBRT. However, the inclusion of neurocognitive and quality-of-life data in clinical trials are still required to better define the role of adjuvant WBRT. Currently, two Phase III trials are underway, one in Europe and one in North America, that will determine the effect of adjuvant WBRT on patients' quality of life, neurocognitive function, and survival. (c) 2008 Elsevier Inc.
引用
收藏
页码:1305 / 1309
页数:5
相关论文
共 32 条
[1]   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 [J].
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 .
LANCET, 2004, 363 (9422) :1665-1672
[2]   Neurocognitive function of patients with brain metastasis who received either whole brain radiotherapy plus stereotactic radiosurgery or radiosurgery alone [J].
Aoyama, Hidefumi ;
Tago, Masao ;
Kato, Norio ;
Toyoda, Tatsuya ;
Kenjyo, Masahiro ;
Hirota, Saeko ;
Shioura, Hiroki ;
Inomata, Taisuke ;
Kunieda, Etsuo ;
Hayakawa, Kazushige ;
Nakagawa, Keiichi ;
Kobashi, Gen ;
Shirato, Hiroki .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2007, 68 (05) :1388-1395
[3]   Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases - A randomized controlled trial [J].
Aoyama, Hidefumi ;
Shirato, Hiroki ;
Tago, Masao ;
Nakagawa, Keiichi ;
Toyoda, Tatsuya ;
Hatano, Kazuo ;
Kenjyo, Masahiro ;
Oya, Natsuo ;
Hirota, Saeko ;
Shioura, Hiroki ;
Kunieda, Etsuo ;
Inomata, Taisuke ;
Hayakawa, Kazushige ;
Katoh, Norio ;
Kobashi, Gen .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2006, 295 (21) :2483-2491
[4]   CNS metastasis: An old problem in a new guise [J].
Aragon-Ching, Jeanny B. ;
Zujewski, Jo Anne .
CLINICAL CANCER RESEARCH, 2007, 13 (06) :1644-1647
[5]   PROPHYLACTIC CRANIAL IRRADIATION FOR PATIENTS WITH SMALL-CELL LUNG-CANCER IN COMPLETE REMISSION [J].
ARRIAGADA, R ;
LECHEVALIER, T ;
BORIE, F ;
RIVIERE, A ;
CHOMY, P ;
MONNET, I ;
TARDIVON, A ;
VIADER, F ;
TARAYRE, M ;
BENHAMOU, S .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1995, 87 (03) :183-190
[6]   Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission [J].
Aupérin, A ;
Arriagada, R ;
Pignon, JP ;
Le Péchoux, C ;
Gregor, A ;
Stephens, RJ ;
Kristjansen, PEG ;
Johnson, BE ;
Ueoka, H ;
Wagner, H ;
Aisner, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (07) :476-484
[7]  
Brain Tumor Progress Review Group. National Institute of Neurological Disorders and Stroke (U.S.) National Cancer Institute (U.S.), 2000, REP BRAIN TUM PROGR
[8]   Effects of radiotherapy on cognitive function in patients with low-grade glioma measured by the Folstein Mini-Mental State Examination [J].
Brown, PD ;
Buckner, JC ;
O'Fallon, JR ;
Iturria, NL ;
Brown, CA ;
O'Neill, BP ;
Scheithauer, BW ;
Dinapoli, RP ;
Arusell, RM ;
Curran, WJ ;
Abrams, R ;
Shaw, EG .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (13) :2519-2524
[9]   A pilot study of neurocognitive function in patients with one to three new brain metastases initially treated with stereotactic radiosurgery alone [J].
Chang, Eric L. ;
Wefel, Jeffrey S. ;
Maor, Moshe H. ;
Hassenbusch, Samuel J., III ;
Mahajan, Anita ;
Lang, Frederick F. ;
Woo, Shiao Y. ;
Mathews, Leni A. ;
Allen, Pamela K. ;
Shiu, Almon S. ;
Meyers, Christina A. .
NEUROSURGERY, 2007, 60 (02) :277-283
[10]   RADIATION-INDUCED DEMENTIA IN PATIENTS CURED OF BRAIN METASTASES [J].
DEANGELIS, LM ;
DELATTRE, JY ;
POSNER, JB .
NEUROLOGY, 1989, 39 (06) :789-796