Whole brain radiotherapy plus stereotactic radiosurgery (WBRT+SRS) versus surgery plus whole brain radiotherapy (OP+WBRT) for 1–3 brain metastases: Results of a matched pair analysis

Rades, Dirk; Kueter, Jan Dirk; Veninga, Theo; Gliemroth, Jan; Schild, Steven E.

doi:10.1016/j.ejca.2008.10.033

Cited by 77 publications

(42 citation statements)

References 15 publications

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“…Median survival 3.4 mo, 1-y survival 12%, ie, comparable results Survival of the contemporary cohort analyzed here is comparable to representative large cohorts from the current decade Knisely et al, 16 Rades et al, 17,18 Suh et al 19 These studies confirm the survival results obtained with SRS, surgery, or WBRT in the current analysis clear, statistically significant observation was the increase in female patients with brain metastases in the contemporary cohort (57% vs 30%, P < .0001), resulting primarily from an increase in the number of female patients with lung cancer (56% of the contemporary lung cancer patients were females compared with 11% in the historical cohort, P < .0001). This shift could be driven by 2 factors, one being an obvious increase in the absolute numbers of women developing lung cancer and therefore subsequent brain metastases, as has been reported in other studies, but also possibly by a worrisome preliminary observation that women with lung cancer may be more susceptible to developing brain metastases compared with men.…”

Section: Argument References Commentsupporting

confidence: 81%

Presentation, patterns of care, and survival in patients with brain metastases

Nieder

Spanne

Mehta

et al. 2010

Cancer

178

106

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. RESULTS: Patterns of care have changed significantly. Contemporary patients received focal treatments such as stereotactic radiosurgery and surgical resection far more frequently. Furthermore, systemic treatment was used more often in contemporary patients, both before and after diagnosis of brain metastasis. Improved survival was observed in the contemporary cohort (P ¼ .03). The 1-year survival rate increased from 15% (95% confidence interval [CI], 7%-25%) to 34% (95% CI, 25%-44%). However, this improvement was largely driven by patients with favorable prognostic features. More than 40% of the patients still belong to unfavorable prognostic groups with limited median survival and little improvement. CONCLUSIONS: Contemporary patients were managed on a much more individualized basis, requiring multidisciplinary case discussion and thorough assessment of prognostic features. Progress has been made, but the overall outcome needs to be improved further. Avoiding overtreatment in patients with poor prognosis is as important as aggressive treatment in patients who might survive for several years. Cancer 2011;117:2505-12.

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Section: Argument References Commentsupporting

confidence: 81%

Presentation, patterns of care, and survival in patients with brain metastases

Nieder

Spanne

Mehta

et al. 2010

Cancer

178

106

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“…On the contrary, Rades et al (2009) suggested that 1-year OS was improved with the use of SRS + WBRT compared to surgery + WBRT (56 vs 47% P = 0.034), for patients with 1-3 BM. Local control rates were also superior in the SRS arm (82 vs 66%, P = 0.006).…”

Section: Surgery Vs Srsmentioning

confidence: 86%

Brain Metastases

Vellayappan¹,

Sahgal²,

Redmond³

et al. 2017

Controversies in Radiation Oncology

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“…Lorsque ces deux dernières techniques sont suivies d'une IPC, la radiochirurgie semble être non inférieure à la chirurgie, c'est ce que conclut Rades dans une étude rétrospective de 2009 sur une population de patients atteints de MC (54 % de CBNPC) [19].…”

Section: Quel Traitement Local Privilégier ?unclassified

Traitement des métastases cérébrales des CBNPC

et al. 2012

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Brain metastasis is a very common complication of lung cancer. Therapeutic methods include surgery, radiotherapy, and systemic therapies including chemotherapy and molecular therapies. The main question is the most relevant use of these therapies, which is still not determined. It depends on many factors such as the control of the lung disease, the patient's general state, and the number of metastases. As a result, the decision needs a coordinated and multidisciplinary team approach.Résumé : Les métastases cérébra-les sont une complication fréquente des cancers broncho-pulmonaires. L'arsenal thérapeutique à disposition du clinicien comprend la chirurgie, la radiochirurgie, la radiothéra-pie et les traitements systémiques (la chimiothérapie et thérapeu-tiques ciblées), mais les séquences thérapeutiques restent à préciser. Les indications thérapeutiques sont très variables et dépendantes du contrôle de la maladie thoracique, de l'état général du patient, du nombre de métastases cérébrales et de la symptomatologie. La décision thérapeutique nécessite toujours une discussion en réunion de concertation pluridisciplinaire.

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Whole brain radiotherapy plus stereotactic radiosurgery (WBRT+SRS) versus surgery plus whole brain radiotherapy (OP+WBRT) for 1–3 brain metastases: Results of a matched pair analysis

Cited by 77 publications

References 15 publications

Presentation, patterns of care, and survival in patients with brain metastases

Presentation, patterns of care, and survival in patients with brain metastases

Brain Metastases

Traitement des métastases cérébrales des CBNPC

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