Change in treatment approach can make quality of life better for patients with brain metastasis
Focal radiation to just the surgical area is the winner for patients after surgery for limited brain metastases. Read the editorial and commentary by Dr. Simon Lo, brain tumor expert and Professor of Radiation Oncology at UW Medicine, on two practice-changing trials that can improve patients ‘quality of life.
Patients with cancer spread to the brain (brain metastasis), who have surgical resection of the tumor, are usually treated with whole brain radiation therapy to prevent tumor regrowth. However, whole brain radiation therapy often reduces the quality of life and brain function by causing symptoms such as hair loss, fatigue, memory loss and decreased thinking ability. A new study from NRG Oncology, one of the largest cooperative clinical trial groups in the US, shows that outcomes are just as good when radiation is focused only to the surgical region rather than the entire brain.
In this practice-changing study, patients with 1, 2, 3 or 4 brain metastases who underwent surgical resection were randomly (i.e. by chance) assigned to whole brain radiation therapy or focal targeted radiation therapy to the surgical cavity with stereotactic radiosurgery. Patients in the stereotactic radiosurgery group were more likely to have improvements in their quality of life and ability to stay independent compared with patients in the whole brain radiation therapy group; decreased thinking ability was significantly less frequent after stereotactic radiosurgery than after whole brain radiation therapy. Survival rates were the same between patients treated with whole brain radiation therapy and those treated with stereotactic radiosurgery. In another trial comparing observation and stereotactic radiosurgery for patients with 1, 2 or 3 brain metastases after surgery, stereotactic radiosurgery resulted in better tumor control in the surgical area compared to no further treatment. Stereotactic radiosurgery is now considered one of the standard treatment options after surgical resection of brain metastases.
For more information and the editorial in the journal Lancet Oncology and comment in Reuters’ Health by Dr. Simon Lo, please click here. For more information on the practice changing trials, please click here.
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