A randomized phase III study of accelerated hyperfractionation versus standard in patients with unresected brain metastases: A report of the radiation therapy oncology group (RTOG) 9104

Murray, Kevin; Scott, Charles; Greenberg, Harvey; Emami, Bahman; Seider, Michael J.; Vora, Nayana; Olson, Craig; Whitton, Anthony; Movsas, Benjamin; Curran, Walter J.

doi:10.1016/s0360-3016(97)00341-6

Cited by 288 publications

(124 citation statements)

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“…Two retrospective trials examined the outcomes of multiple treatments including WBRT, surgery, chemotherapy, or supportive care 42,43 . Twelve studies examined the use of various WBRT dose fractionation schedules 6,10,22,28,[44][45][46][47][48][49][50][51] , and seven trials assessed the efficacy of radiosensitizers and WBRT as compared with WBRT alone 9,21,24,25,[52][53][54] . Chemotherapy and WBRT were compared in eight studies 7,8,[55][56][57][58][59][60] .…”

Section: Multiple Brain Metastasesmentioning

confidence: 99%

“…The objective of WBRT is to provide symptomatic relief, to allow for tapering of the dose of corticosteroids, and to possibly improve survival. Although many trials have shown that WBRT can reduce neurologic symptoms, median survival following a diagnosis of brain metastases is generally only 3-6 months 6 . Patients with a solitary brain metastasis, good performance status, and controlled extracranial disease may be considered for more aggressive treatment such as surgery with postoperative radiotherapy or stereotactic radiosurgery.…”

Section: Introductionmentioning

confidence: 99%

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Quality of Life in Brain Metastases Radiation Trials: A Literature Review

et al. 2008

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BackgroundAn estimated 20%-40% of cancer patients will develop brain metastases. Whole-brain radiotherapy (WBRT) is the standard treatment for patients with brain metastases. Although WBRT can reduce neurologic symptoms, the median survival following WBRT is between 3 and 6 months. Given this limited survival, it is important to consider quality of life (QOL) when treating patients with brain metastases. However, few studies have focused on QOL and improvement in patient-rated symptoms as primary outcomes. ObjectiveFor an accurate measurement of the extent to which previous trials have utilized QOL tools to evaluate the efficacy of WBRT for treatment of brain metastases, we undertook a literature review to examine the common endpoints and QOL instruments used. MethodsWe conducted a systematic search using the MEDLINE (1950( to December 2007 and Cochrane Central Register of Controlled Trials (4th quarter 2007) databases. Eligible studies investigated WBRT in one of the study arms. The following outcomes were included: median survival, overall survival, neurologic function, 1-year local control, and overall response; use of QOL instruments, performance status scales, and neurologic function assessments; and use of other assessment tools. Patient-rated QOL instruments were defined as those that strove to assess all dimensions of QOL; observerrated performance instruments such as the Karnofsky performance status (KPS) were deemed to be performance scales. ResultsWe identified sixty-one trials that included WBRT nine evaluated the treatment of a single brain metastasis, and fifty-two evaluated the treatment of multiple brain metastases. Although fifty-five of the trials employed a QOL instrument, few trials focused on QOL as an outcome. We found 23 different instruments used to evaluate QOL. The most commonly employed instrument was the KPS (n = 33), followed by various neurologic function classification scales (n = 21). A preponderance of the studies used 1 (n = 26, 43%) or 2 (n = 21, 34%) QOL instruments.A total of fourteen published trials on brain metastases included an evaluation of the study population's QOL. Those trials included three that used the Functional Assessment of Cancer Therapy-General scale and Brain subscale instrument, three that used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (C30) and the Brain Cancer Module 20 instrument, two that used study-designed QOL instruments, one that used the Edmonton Symptom Assessment Scale, two that used the Spitzer Quality of Life index, and three that used the KPS to evaluate QOL. Some trials reported deterioration in QOL after WBRT in patients with poorer prognosis; other trials detected an improvement in QOL after WBRT in patients with better prognosis. ConclusionsTo date, fourteen trials in brain metastases that have included an evaluation of the study population's QOL have been published. Although some studies showed that certain parameters of QOL deteriorate after WBRT, other studies showed that Q...

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Section: Multiple Brain Metastasesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quality of Life in Brain Metastases Radiation Trials: A Literature Review

et al. 2008

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“…ОВГМ является методом вы-бора при множественных метастазах с или без экстракра-ниальных проявлений болезни, но обеспечивает медиану выживаемости лишь 3-10 мес. Рандомизированное ис-следование Radiation Therapy Oncology Group (RTOG), сравнивающим гипрефракционированное облучение (1,6 Гр 2 раза в сутки) до СОД 54,4 Гр не показало приро-ста выживаемости по сравнению с традиционным фрак-ционированием дозы (30 Гр за 10 фракций) [33].…”

Section: таблица 1 определение Rpa-класса (по Rtog 1997)unclassified

Treatment in patients with ovarian cancer metastasizing to the brain

Зайцев¹,

Новикова²,

Kirsanova³

et al. 2015

Onkol. Z. im. P.A. Gercena

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Ключевые слова: метастазы в головном мозге, внутричерепные новообразования, рак яичников.The review gives the data available in the literature on the problem in treating patients with intracranial metastases from ovarian cancer (OC). The incidence of secondary brain involvement in OC has increased 6.5-fold in the last 20 years. The optimal treatment policy for intracerebral metastases from OC remains a complicated problem. If the foci are more than 3 cm, surgical treatment followed by chemotherapy and radiotherapy is recommended. If the foci are smaller, brain stereotactic radiosurgery followed by chemotherapy is the method of choice. The authors' investigation was conducted in 8 patients with brain metastases from OC, who had undergone microsurgical removal of a metastatic brain tumor, followed by multimodality treatment. After multimodality treatment, median overall survival was 15.0 months and median relapse-free survival was 11.5 months. Metastatic brain involvement is traditionally considered as a final manifestation of the disease and characterized by an extremely pessimistic prognosis. Our experience demonstrates that combination treatment involving surgery results in prolonged survival in patients who have a satisfactory quality of life. Keywords: breast cancer, intracranial neoplasms, ovarian cancer. © Коллектив авторов, 2015Кирсанова Ольга

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“…Depending on the patients' general health, radiotherapy may lead to improved survival (up to approximately 4 months) in selected cases. [3][4][5] However, any treatment must be carefully tailored to avoid unnecessary treatment burden and toxicity during the last few weeks of life.…”

Section: Prognosismentioning

confidence: 99%