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

2009 ◽  
Vol 96 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Laurie E. Gaspar ◽  
Minesh P. Mehta ◽  
Roy A. Patchell ◽  
Stuart H. Burri ◽  
Paula D. Robinson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Clinical Practice ◽  
Brain Metastases ◽  
Clinical Practice Guideline ◽  
Evidence Based ◽  
Newly Diagnosed ◽  
Whole Brain Radiation ◽  
Brain Radiation

scholarly journals The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline

2009 ◽  
Vol 96 (1) ◽  
pp. 33-43 ◽  
Author(s):  
Steven N. Kalkanis ◽  
Douglas Kondziolka ◽  
Laurie E. Gaspar ◽  
Stuart H. Burri ◽  
Anthony L. Asher ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Brain Metastases ◽  
Surgical Resection ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Evidence Based ◽  
Newly Diagnosed

scholarly journals The role of chemotherapy in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline

2009 ◽  
Vol 96 (1) ◽  
pp. 71-83 ◽  
Author(s):  
Minesh P. Mehta ◽  
Nina A. Paleologos ◽  
Tom Mikkelsen ◽  
Paula D. Robinson ◽  
Mario Ammirati ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Brain Metastases ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Evidence Based ◽  
Newly Diagnosed

The Role of Radiosurgery to the Tumor Bed After Resection of Brain Metastases

Neurosurgery ◽  
2012 ◽  
Vol 72 (3) ◽  
pp. 317-326 ◽  
Author(s):  
Jared H. Gans ◽  
Daniel M.S. Raper ◽  
Ashish H. Shah ◽  
Amade Bregy ◽  
Deborah Heros ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Local Control ◽  
Total Resection ◽  
Whole Brain Radiation ◽  
Brain Radiation

Abstract BACKGROUND: Optimal postoperative management paradigm for brain metastases remains controversial. OBJECTIVE: To conduct a systematic review of the literature to understand the role of postoperative stereotactic radiosurgery after resection of brain metastases. METHODS: We performed a MEDLINE search of the literature to identify series of patients with brain metastases treated with stereotactic radiosurgery after surgical resection. Outcomes including overall survival, local control, distant intracranial failure, and salvage therapy use were recorded. Patient, tumor, and treatment factors were correlated with outcomes through the use of the Pearson correlation and 2-way Student t test as appropriate. RESULTS: Fourteen studies involving 629 patients were included. Median survival for all studies was 14 months. Local control was correlated with the median volume treated with radiosurgery (r = −0.766, P < .05) and with the rate of gross total resection (r = .728, P < .03). Mean crude local control was 83%; 1-year local control was 85%. Distant intracranial failure occurred in 49% of cases, and salvage whole-brain radiation therapy was required in 29% of cases. Use of a radiosurgical margin did not lead to increased local control or overall survival. CONCLUSION: Our systematic review supports the use of radiosurgery as a safe and effective strategy for adjuvant treatment of brain metastases, particularly when gross total resection has been achieved. With all limitations of comparisons between studies, no increase in local recurrence or decrease in overall survival compared with rates with adjuvant whole-brain radiation therapy was found.

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