Neurocognitive Function of Patients with Brain Metastasis Who Received Either Whole Brain Radiotherapy Plus Stereotactic Radiosurgery or Radiosurgery Alone

Aoyama, Hidefumi; Tago, Masao; Kato, Norio; Toyoda, T.; Kenjyo, Masahiro; Hirota, Saeko; Shioura, Hiroki; Inomata, Taisuke; Kunieda, Etsuo; Hayakawa, Kazushige; Nakagawa, Keiichi; Kobashi, Gén; Shirato, Hiroki

doi:10.1016/j.ijrobp.2007.03.048

Cited by 497 publications

(320 citation statements)

References 26 publications

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“…However, to longterm survivors, WBRT could be a cause of continuous deterioration of neurological function (Aoyama et al, 2007). In another trail about NSCLC, Kundu S et al also shows that stereotactic body radiotherapy has minimal toxicity but good efficacy (Kundu et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Whole Brain Radiotherapy Combined with Stereotactic Radiotherapy Versus Stereotactic Radiotherapy Alone for Brain Metastases: a Meta-analysis

Duan¹,

Zeng²,

Yang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 15 (2), 911-915 IntroductionCurrently, an increasing number of patients with cancer develop brain metastases, over 100,000 patients were diagnosed brain metastases each year in the United States (Stelzer et al., 2013). Brain metastases leave patients with a very poor prognosis, and the average survival was 1-2 months without treatment (Patil et al., 2012). The most common primary cancers metastasis to brain were lung cancer, renal carcinoma, breast cancer and esophagus cancer (Schouten et al., 2002). Patients with one metastatic lesion and well-controlled systemic disease can get good prognosis after surgery, however, the use of surgery in the treatment of brain metastases still remains controversial (Yaeger et al., 2013).In 1970s, the first option for brain metastases was the whole brain radiotherapy (WBRT), in recent years, the use of WBRT has decreased mainly because of the late toxicities are not self-limited and may have severe consequences that produce irreversible neurocognitive degeneration such as leukoencephalopathy, memory loss, emotional dysfunction, dementia, stupor, and coma (Abe et al., 2012;Mctyre et al., 2013

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Section: Discussionmentioning

confidence: 99%

Whole Brain Radiotherapy Combined with Stereotactic Radiotherapy Versus Stereotactic Radiotherapy Alone for Brain Metastases: a Meta-analysis

Duan¹,

Zeng²,

Yang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…1,4,27,29,40 Additionally, brain metastases are particularly well suited for radiosurgery given that these lesions tend to have clear margins. 13 When used as a primary treatment for solitary metastasis, radiosurgery has been associated with local tumor control rates of 73%-94% and less morbidity than WBRT.…”

mentioning

confidence: 99%

Survival after surgery and stereotactic radiosurgery for patients with multiple intracranial metastases: results of a single-center retrospective study

Smith¹,

Lall²,

Lall³

et al. 2014

JNS

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Object Patients with systemic cancer and a single brain metastasis who undergo treatment with resection plus radiotherapy live longer and have a better quality of life than those treated with radiotherapy alone. Historically, whole-brain radiotherapy (WBRT) has been the mainstay of radiation therapy; however, it is associated with significant delayed neurocognitive sequelae. In this study, the authors looked at survival in patients with single and multiple intracranial metastases who had undergone surgery and adjuvant stereotactic radiosurgery (SRS) to the tumor bed and synchronous lesions. Methods The authors retrospectively reviewed the records from an 8-year period at a single institution for consecutive patients with brain metastases treated via complete resection of dominant lesions and adjuvant radiosurgery. The cohort was analyzed for time to local progression, synchronous lesion progression, new intracranial lesion development, systemic progression, and overall survival. The Kaplan-Meier method (stratified by age, sex, tumor histology, and number of intracranial lesions prior to surgery) was used to calculate both progression-free and overall survival. A Cox proportional-hazards regression model was also fitted with the number of intracranial lesions as the predictor and survival as the outcome controlling for disease severity, age, sex, and primary histology. Results The median overall follow-up among the 150-person cohort eligible for analysis was 17 months. Patients had an average age of 46.2 years (range 16–82 years), and 62.7% were female. The mean (± standard deviation) number of intracranial lesions per patient was 2.5 ± 2.3. The mean time between surgery and stereotactic radiosurgery (SRS) was 3.2 ± 4.1 weeks. Primary cancers included lung cancer (43.3%), breast cancer (21.3%), melanoma (10.0%), renal cell carcinoma (6.7%), and colon cancer (6.7%). The average number of isocenters per treated lesion was 7.6 ± 6.6, and the average treatment dose was 17.8 ± 2.8 Gy. One-year survival for patients in this cohort was 52%, and the 1-year local control rate was 77%. The median (±standard error) overall survival was 13.2 ± 1.9 months. There was no difference in survival between patients with a single lesion and those with multiple lesions (p = 0.319) after controlling for age, sex, and histology of primary tumor. Patients with primary breast histology had the greatest overall median survival (22.9 ± 6.2 months); patients with colorectal cancer had the shortest overall median survival (5.3 ± 1.8 months). The most common cause of death in this series was systemic progression (79%). Conclusions These results confirm that 1-year survival for patients with multiple intracranial metastases treated with resection followed by SRS to both the tumor bed and synchronous lesions is similar to established outcomes for patients with a single intracranial metastasis.

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“…Aoyama et al 13 (2007) used the mini-mental state examination to assess cognitive function, and found that the main factor related to cognitive function is tumor control. Cognitive worsening was earlier the single treatment group (7.6 months vs. 16.5 months, p=0.05).…”

Section: Resultsmentioning

confidence: 99%

Treatment of brain metastases

Lima

Carvalho

Silva

et al. 2016

Rev. Assoc. Med. Bras.

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The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize procedures to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

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Neurocognitive Function of Patients with Brain Metastasis Who Received Either Whole Brain Radiotherapy Plus Stereotactic Radiosurgery or Radiosurgery Alone

Cited by 497 publications

References 26 publications

Whole Brain Radiotherapy Combined with Stereotactic Radiotherapy Versus Stereotactic Radiotherapy Alone for Brain Metastases: a Meta-analysis

Whole Brain Radiotherapy Combined with Stereotactic Radiotherapy Versus Stereotactic Radiotherapy Alone for Brain Metastases: a Meta-analysis

Survival after surgery and stereotactic radiosurgery for patients with multiple intracranial metastases: results of a single-center retrospective study

Treatment of brain metastases

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