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Whole-brain radiation therapy for brain metastases: detrimental or beneficial?
Stereotactic radiosurgery is frequently used, either alone or together with whole-brain radiation therapy to treat brain metastases from solid tumors. Certain experts and radiation oncology groups have proposed replacing whole-brain radiation therapy with stereotactic radiosurgery alone for the mana...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517629/ https://www.ncbi.nlm.nih.gov/pubmed/26215106 http://dx.doi.org/10.1186/s13014-015-0466-9 |
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author | Gemici, Cengiz Yaprak, Gokhan |
author_facet | Gemici, Cengiz Yaprak, Gokhan |
author_sort | Gemici, Cengiz |
collection | PubMed |
description | Stereotactic radiosurgery is frequently used, either alone or together with whole-brain radiation therapy to treat brain metastases from solid tumors. Certain experts and radiation oncology groups have proposed replacing whole-brain radiation therapy with stereotactic radiosurgery alone for the management of brain metastases. Although randomized trials have favored adding whole-brain radiation therapy to stereotactic radiosurgery for most end points, a recent meta-analysis demonstrated a survival disadvantage for patients treated with whole-brain radiation therapy and stereotactic radiosurgery compared with patients treated with stereotactic radiosurgery alone. However the apparent detrimental effect of adding whole-brain radiation therapy to stereotactic radiosurgery reported in this meta-analysis may be the result of inhomogeneous distribution of the patients with respect to tumor histologies, molecular histologic subtypes, and extracranial tumor stages between the groups rather than a real effect. Unfortunately, soon after this meta-analysis was published, even as an abstract, use of whole-brain radiation therapy in managing brain metastases has become controversial among radiation oncologists. The American Society of Radiation Oncology recently recommended, in their “Choose Wisely” campaign, against routinely adding whole-brain radiation therapy to stereotactic radiosurgery to treat brain metastases. However, this situation creates conflict for radiation oncologists who believe that there are enough high level of evidence for the effectiveness of whole-brain radiation therapy in the treatment of brain metastases. |
format | Online Article Text |
id | pubmed-4517629 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-45176292015-07-29 Whole-brain radiation therapy for brain metastases: detrimental or beneficial? Gemici, Cengiz Yaprak, Gokhan Radiat Oncol Commentary Stereotactic radiosurgery is frequently used, either alone or together with whole-brain radiation therapy to treat brain metastases from solid tumors. Certain experts and radiation oncology groups have proposed replacing whole-brain radiation therapy with stereotactic radiosurgery alone for the management of brain metastases. Although randomized trials have favored adding whole-brain radiation therapy to stereotactic radiosurgery for most end points, a recent meta-analysis demonstrated a survival disadvantage for patients treated with whole-brain radiation therapy and stereotactic radiosurgery compared with patients treated with stereotactic radiosurgery alone. However the apparent detrimental effect of adding whole-brain radiation therapy to stereotactic radiosurgery reported in this meta-analysis may be the result of inhomogeneous distribution of the patients with respect to tumor histologies, molecular histologic subtypes, and extracranial tumor stages between the groups rather than a real effect. Unfortunately, soon after this meta-analysis was published, even as an abstract, use of whole-brain radiation therapy in managing brain metastases has become controversial among radiation oncologists. The American Society of Radiation Oncology recently recommended, in their “Choose Wisely” campaign, against routinely adding whole-brain radiation therapy to stereotactic radiosurgery to treat brain metastases. However, this situation creates conflict for radiation oncologists who believe that there are enough high level of evidence for the effectiveness of whole-brain radiation therapy in the treatment of brain metastases. BioMed Central 2015-07-28 /pmc/articles/PMC4517629/ /pubmed/26215106 http://dx.doi.org/10.1186/s13014-015-0466-9 Text en © Gemici and Yaprak. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Commentary Gemici, Cengiz Yaprak, Gokhan Whole-brain radiation therapy for brain metastases: detrimental or beneficial? |
title | Whole-brain radiation therapy for brain metastases: detrimental or beneficial? |
title_full | Whole-brain radiation therapy for brain metastases: detrimental or beneficial? |
title_fullStr | Whole-brain radiation therapy for brain metastases: detrimental or beneficial? |
title_full_unstemmed | Whole-brain radiation therapy for brain metastases: detrimental or beneficial? |
title_short | Whole-brain radiation therapy for brain metastases: detrimental or beneficial? |
title_sort | whole-brain radiation therapy for brain metastases: detrimental or beneficial? |
topic | Commentary |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517629/ https://www.ncbi.nlm.nih.gov/pubmed/26215106 http://dx.doi.org/10.1186/s13014-015-0466-9 |
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