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Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology
PURPOSE: The treatment of brain metastases (BM) has changed considerably in recent years and in particular, the management of multiple BM is currently undergoing a paradigm shift and treatment may differ from current guidelines. This survey was designed to analyze the patterns of care in the managem...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997832/ https://www.ncbi.nlm.nih.gov/pubmed/33620657 http://dx.doi.org/10.1007/s11060-021-03714-w |
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author | Kraft, Johannes Mayinger, Michael Willmann, Jonas Brown, Michelle Tanadini-Lang, Stephanie Wilke, Lotte Guckenberger, Matthias Andratschke, Nicolaus |
author_facet | Kraft, Johannes Mayinger, Michael Willmann, Jonas Brown, Michelle Tanadini-Lang, Stephanie Wilke, Lotte Guckenberger, Matthias Andratschke, Nicolaus |
author_sort | Kraft, Johannes |
collection | PubMed |
description | PURPOSE: The treatment of brain metastases (BM) has changed considerably in recent years and in particular, the management of multiple BM is currently undergoing a paradigm shift and treatment may differ from current guidelines. This survey was designed to analyze the patterns of care in the management of multiple BM. METHODS: An online survey consisting of 36 questions was distributed to the members of the German Society for Radiation Oncology (DEGRO). RESULTS: In total, 193 physicians out of 111 institutions within the German Society for Radiation oncology responded to the survey. Prognostic scores for decision making were not used regularly. Whole brain radiotherapy approaches (WBRT) are the preferred treatment option for patients with multiple BM, although stereotactic radiotherapy treatments are chosen by one third depending on prognostic scores and overall number of BM. Routine hippocampal avoidance (HA) in WBRT is only used by a minority. In multiple BM of driver-mutated non-small cell lung cancer origin up to 30% favor sole TKI therapy as upfront treatment and would defer upfront radiotherapy. CONCLUSION: In multiple BM WBRT without hippocampal avoidance is still the preferred treatment modality of choice regardless of GPA and mutational status, while SRT is only used in patients with good prognosis. Evidence for both, SRS and hippocampal avoidance radiotherapy, is growing albeit the debate over the appropriate treatment in multiple BM is yet not fully clarified. Further prospective assessment of BM management—ideally as randomized trials—is required to align evolving concepts with the proper evidence and to update current guidelines. |
format | Online Article Text |
id | pubmed-7997832 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-79978322021-04-16 Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology Kraft, Johannes Mayinger, Michael Willmann, Jonas Brown, Michelle Tanadini-Lang, Stephanie Wilke, Lotte Guckenberger, Matthias Andratschke, Nicolaus J Neurooncol Clinical Study PURPOSE: The treatment of brain metastases (BM) has changed considerably in recent years and in particular, the management of multiple BM is currently undergoing a paradigm shift and treatment may differ from current guidelines. This survey was designed to analyze the patterns of care in the management of multiple BM. METHODS: An online survey consisting of 36 questions was distributed to the members of the German Society for Radiation Oncology (DEGRO). RESULTS: In total, 193 physicians out of 111 institutions within the German Society for Radiation oncology responded to the survey. Prognostic scores for decision making were not used regularly. Whole brain radiotherapy approaches (WBRT) are the preferred treatment option for patients with multiple BM, although stereotactic radiotherapy treatments are chosen by one third depending on prognostic scores and overall number of BM. Routine hippocampal avoidance (HA) in WBRT is only used by a minority. In multiple BM of driver-mutated non-small cell lung cancer origin up to 30% favor sole TKI therapy as upfront treatment and would defer upfront radiotherapy. CONCLUSION: In multiple BM WBRT without hippocampal avoidance is still the preferred treatment modality of choice regardless of GPA and mutational status, while SRT is only used in patients with good prognosis. Evidence for both, SRS and hippocampal avoidance radiotherapy, is growing albeit the debate over the appropriate treatment in multiple BM is yet not fully clarified. Further prospective assessment of BM management—ideally as randomized trials—is required to align evolving concepts with the proper evidence and to update current guidelines. Springer US 2021-02-23 2021 /pmc/articles/PMC7997832/ /pubmed/33620657 http://dx.doi.org/10.1007/s11060-021-03714-w Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Clinical Study Kraft, Johannes Mayinger, Michael Willmann, Jonas Brown, Michelle Tanadini-Lang, Stephanie Wilke, Lotte Guckenberger, Matthias Andratschke, Nicolaus Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology |
title | Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology |
title_full | Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology |
title_fullStr | Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology |
title_full_unstemmed | Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology |
title_short | Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology |
title_sort | management of multiple brain metastases: a patterns of care survey within the german society for radiation oncology |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997832/ https://www.ncbi.nlm.nih.gov/pubmed/33620657 http://dx.doi.org/10.1007/s11060-021-03714-w |
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