Whole-Brain Radiotherapy in the Management of Brain Metastasis

2006 ◽  
Vol 24 (8) ◽  
pp. 1295-1304 ◽  
Author(s):  
Deepak Khuntia ◽  
Paul Brown ◽  
Jing Li ◽  
Minesh P. Mehta
Keyword(s):  
Standard Treatment ◽  
Treatment Approach ◽  
Whole Brain Radiotherapy ◽  
Review Article ◽  
Neurocognitive Deficits ◽  
Survival Times ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
New Directions

Brain metastases are an important cause of morbidity and mortality, afflicting nearly 170,000 Americans annually. The prognosis for these patients is poor, with median survival times measured in months. In this review article, we present the standard treatment approach of whole-brain radiotherapy and discuss new directions, including the role of chemical modifiers and the management and prevention of neurocognitive deficits.

Stereotactic Radiosurgery: Adjacent Tissue Injury and Response after High-Dose Single Fraction Radiation—Part II: Strategies for Therapeutic Enhancement, Brain Injury Mitigation, and Brain Injury Repair

Neurosurgery ◽  
2007 ◽  
Vol 60 (5) ◽  
pp. 799-814 ◽  
Author(s):  
Bryan C. Oh ◽  
Charles Y. Liu ◽  
Michael Y. Wang ◽  
Paul G. Pagnini ◽  
Cheng Yu ◽  
...  
Keyword(s):  
Brain Injury ◽  
Tissue Injury ◽  
Whole Brain Radiotherapy ◽  
Molecular Data ◽  
Phase Iii ◽  
High Dose ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Axonal Regrowth

Abstract IN THE FIRST part of this series, we reviewed the histological, radiographic, and molecular data gathered regarding the brain parenchymal response to radiosurgery and suggested future studies that could enhance our understanding of the topic. With this article, we begin by addressing methods of potentiating the effect of radiosurgery on target lesions of the central nervous system. Much of the work on potentiating the effects of cranial radiation has been performed in the field of whole-brain radiotherapy. Data from Phase III trials evaluating the efficacy of various agents as radiosensitizers or radioenhancers in whole-brain radiotherapy are reviewed, and trials for investigating certain agents as enhancers of radiosurgery are suggested. The roles of gene therapy and nanotechnology in enhancing the therapeutic efficacy of radiosurgery are then addressed. Focus is then shifted to a discussion of strategies of protecting healthy tissue from the potentially deleterious aspects of the brain's response to radiosurgery that were presented in the first article of this series. Finally, comments are made regarding the role of neural progenitor or stem cells in the repair of radiation-induced brain injury after radiosurgery. The importance of both the role of the extracellular matrix and properly directed axonal regrowth leading to appropriate target reinnervation is highlighted.

The Changing Role of Whole-Brain Radiotherapy

JAMA Oncology ◽  
2017 ◽  
Vol 3 (8) ◽  
pp. 1021 ◽  
Author(s):  
Minesh P. Mehta ◽  
Hidefumi Aoyama ◽  
Vinai Gondi
Keyword(s):  
Whole Brain Radiotherapy ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Changing Role

Clinical Outcomes of Upfront Stereotactic Radiosurgery Alone for Patients With 5 to 15 Brain Metastases

Neurosurgery ◽  
2018 ◽  
Vol 85 (2) ◽  
pp. 257-263 ◽  
Author(s):  
Ryan T Hughes ◽  
Emory R McTyre ◽  
Michael LeCompte ◽  
Christina K Cramer ◽  
Michael T Munley ◽  
...  
Keyword(s):  
Overall Survival ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Clinical Outcomes ◽  
Whole Brain Radiotherapy ◽  
Cox Proportional Hazards ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Increased Risk

Abstract BACKGROUND The role of primary stereotactic radiosurgery (SRS) for patients with >4 brain metastases (BM) remains controversial. OBJECTIVE To compare the outcomes of patients treated with upfront SRS alone for 1, 2 to 4, and 5 to 15 BM and assess for predictors of clinical outcomes in the 5 to 15 BM group. METHODS A total of 478 patients treated with upfront SRS were stratified by number of lesions: 220 had 1 BM, 190 had 2 to 4 BM, and 68 patients had 5 to 15 BM. Overall survival and whole brain radiotherapy-free survival were estimated using the Kaplan–Meier method. The cumulative incidences of local failure and distant brain failure (DBF) were estimated using competing risks methodology. Clinicopathologic and dosimetric parameters were evaluated as predictors of survival and DBF in patients with 5 to 15 BM using Cox proportional hazards. RESULTS Median overall survival was 8.0, 6.3, and 4.7 mo for patients with 1, 2 to 4, and 5 to 15 BM, respectively (P = .14). One-year DBF was 27%, 44%, and 40%, respectively (P = .01). Salvage SRS and whole brain radiotherapy rates did not differ. Progressive extracranial disease and gastrointestinal primary were associated with poor survival while RCC primary was associated with increased risk of DBF. No evaluated dose-volume parameters predicted for death, neurologic death or toxicity. CONCLUSION SRS for 5 to 15 BM is well tolerated without evidence of an associated increase in toxicity, treatment failure, or salvage therapy. Further prospective, randomized studies are warranted to clarify the role of SRS for these patients.

Possible role of aprepitant for intractable nausea and vomiting following whole brain radiotherapy—a case report

2016 ◽  
Vol 5 (4) ◽  
pp. 315-318 ◽  
Author(s):  
Deepti Ahuja ◽  
Sachidanand J. Bharati ◽  
Nishkarsh Gupta ◽  
Ritesh Kumar ◽  
Sushma Bhatnagar
Keyword(s):  
Case Report ◽  
Whole Brain Radiotherapy ◽  
Nausea And Vomiting ◽  
Whole Brain ◽  
Brain Radiotherapy

scholarly journals Contemporary Review of the Management of Brain Metastasis with Radiation

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Deepak Khuntia
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Standard Treatment ◽  
Review Article ◽  
Morbidity And Mortality ◽  
Neurocognitive Deficits ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
Novel Approaches ◽  
Brain Radiation

Brain metastases are an important cause of morbidity and mortality, afflicting approximately 200,000 Americans annually. The prognosis for these patients is poor, with median survivals typically measured in months. In this review article, we present the standard treatment approaches with whole brain radiation and as well as novel approaches in the prevention of neurocognitive deficits.

scholarly journals Role of whole brain radiotherapy in the management of infratentorial metastases from lung and breast cancer

2021 ◽  
Author(s):  
Bernardo Cacho-Díaz ◽  
Alejandra Alvarez-Alvarez ◽  
Karen Salmerón-Moreno ◽  
Oscar Rodríguez-Mayoral ◽  
Bernardino Gabriel Santiago-Concha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Whole Brain Radiotherapy ◽  
Whole Brain ◽  
Brain Radiotherapy
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