American College of Radiology Appropriateness Criteria on Multiple Brain Metastases

Gregory M.M. Videtic, Laurie E. Gaspar, Amr M. Aref, Isabelle M. Germano, Brian J. Goldsmith, Joseph P. Imperato, Karen J. Marcus, Michael W. McDermott, Mark W. McDonald, Roy A. Patchell, H. Ian Robins, C. Leland Rogers, John H. Suh, Aaron H. Wolfson, Franz J. Wippold

Research output: Contribution to journalReview article

28 Scopus citations

Abstract

Whole-brain radiotherapy is an effective palliative treatment for patients with multiple brain metastases. Approximately half of these patients experience an improvement in their neurologic symptoms. However, a majority of them do not achieve local control and frequently die of progressive brain disease. Any perceived benefits from surgery need verification in prospective, randomized, Phase III clinical trials. The effectiveness of SRS for patients with multiple metastases may be primarily a function of proper patient selection, but it probably cannot replace the benefits of WBRT, as demonstrated in the Aoyama trial (34). Effective radiation sensitizers are needed because WBRT alone, even in doses of 5000-5440 cGy, has not been associated with an improved survival outcome. Future trials of WBRT must include prospective measurement of neurocognitive functioning before and after treatment as a standard component of the patient's assessment.

Original languageEnglish (US)
Pages (from-to)961-965
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume75
Issue number4
DOIs
StatePublished - Nov 15 2009

Keywords

  • Appropriateness criteria
  • Multiple brain metastases
  • Radiosurgery
  • Surgery
  • Whole-brain radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

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    Videtic, G. M. M., Gaspar, L. E., Aref, A. M., Germano, I. M., Goldsmith, B. J., Imperato, J. P., Marcus, K. J., McDermott, M. W., McDonald, M. W., Patchell, R. A., Robins, H. I., Rogers, C. L., Suh, J. H., Wolfson, A. H., & Wippold, F. J. (2009). American College of Radiology Appropriateness Criteria on Multiple Brain Metastases. International Journal of Radiation Oncology Biology Physics, 75(4), 961-965. https://doi.org/10.1016/j.ijrobp.2009.07.1720