In response to Fogarty et al. and why adjuvant whole brain radiotherapy is not recommended routinely

BMC Cancer

Correspondence

Andrew P. Pullar¹  Mark B. Pinkham²  Matthew C. Foote²  Arjun Sahgal³ 

[1]Department of Radiation Oncology, Princess Alexandra Hospital, 4102, Brisbane, Queensland, Australia

[2]Queensland University of Technology, Brisbane, Queensland, Australia

[3]Department of Radiation Oncology, Princess Alexandra Hospital, 4102, Brisbane, Queensland, Australia

[4]University of Queensland, Brisbane, Queensland, Australia

[5]Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

关键词: Brain metastases;    Melanoma;    Radiosurgery;    Gamma knife;    Whole brain radiotherapy;   

DOI  :  10.1186/s12885-017-3672-z

 received in 2016-11-28, accepted in 2017-10-04,  发布年份 2017

来源: Springer

【 摘 要 】

The routine use of adjuvant whole brain radiotherapy (AWBRT) after surgery or stereotactic radiosurgery is now discouraged by a number of international expert panels. Three decades of randomised studies have shown that, although AWBRT improves radiological measures of intracranial disease control, the clinical benefit is unclear and it is also associated with inferior quality of life and neurocognitive function. The number of patients with melanoma in these trials was low, but data suggesting that treatment-related side effects should vary according to histology of the primary malignancy are lacking. For metastatic melanoma, the role of AWBRT to control microscopic disease in the brain is also a less relevant concern because systemic therapies with intracranial activity are now available. Whether AWBRT is useful in select patients deemed at high risk of neurologic death remains undefined.

【 授权许可】

CC BY   
© The Author(s). 2017