Palliation

Neuro-Oncology   

Questions discussed in this category



Do you ever allow patients to receive a couple of cycles of systemic therapy first if there is high burden of disease? What is the maximum time after ...

In a patient with metastatic cancer to the lumbar spine and epidural disease on CT who presents back pain and leg weakness: Is a whole spine MRI in...

Do all patients with brain metastases get started on anticonvulsants?  Do you decide based on extent of edema, tumor size, or something else?&nb...

This has become standard practice at our institution for patients with a good performance status, with whole brain radiotherapy given after the comple...

Does fractionation (or location) influence this decision? What is your preferred steroid dose?

In patients with contraindications to receiving an MRI scan, are other imaging modalities sufficient to treat patients with SRS?

Should it include the entire brain (normal brain + target) or just the normal brain (brain - target)?  How does the V10 or V12 constraint change ...

What maximum dose do you allow to “connect” adjacent metastatic lesions receiving SRS/SRT? What is this value for one-, three-, and five-...

Is there evidence that supports/refutes the safety of concurrent use?

Do you prefer WBRT, IT chemo or targeted systemic therapy and what is your preference on the sequence of therapies?

In a palliative setting, how long would you wait to initiate WBRT?

If progression is proven by imaging modality (MRI spectroscopy, perfusion and PET/CT), is there evidence for retreatment with a second course of SRS?&...

Would you suspect progressive disease v. radiation necrosis vs optic neuritis due to immunotherapy. Eyes were within radiation field 8 months ago.&nbs...

Specifically, how do you explain potential cognitive decline in a way that explains what changes they can expect in their daily lives?

Can SRS or whole brain radiotherapy be reserved for progression in these young, healthy patients?

Would you feel comfortable treating with palliative radiation without neurosurgical assessment? Are these patients at increased risk for neurolog...

There are solid data from Emory, Korea and others suggesting that is as effective as single fraction SRS but has less complications. 

To what degree, if any, is a neurosurgeon involved in the planning of SRS for brain metastases?

The 2014 "Choosing Wisely" list, released this past September, includes the assertion that we should not "routinely add adjuvant whole brain radiation...

What are the best options to treat a patient with brain metastasis confined to the posterior fossa if the patient is young, has a favorable cancer, gr...

Can the drug continue during radiation therapy or should it be discontinued at a specified time prior to initiation of radiation?

For a patient who has completed 40 hyperbaric sessions with steroids with little improvement, what other options exist?

In a patient with multiple brain metastases from NSCLC, is this reasonable?

Any advice on how to safely incorporate it into our practice?

The most frequent argument against whole brain RT is debilitating toxicity. However, I am having a hard time finding the most evidence based data on h...

In reading through the policy of one of my state's private insurance companies, I came across something with which I'm not familiar, namely treating p...

I'm aware of a number of publications that suggest that after 1-2 years, the cord should be able to handle about 50% of the original tolerance dose. &...

It is my impression that for brain metastases >3 cm it may be preferable to deliver fractionated SRT versus the RTOG dose of 15 Gy SRS, if WBRT is ...


Papers discussed in this category


Clinical oncology (Royal College of Radiologists (Great Britain)), 2007-09

Radiation oncology (London, England), 2014-01-03

Neuro-oncology, 2013-10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-12-01

J. Clin. Oncol., 2020 Feb 14

Lancet, 2016 Sep 2

Neuro-oncology, 2018-04-09

Int J Radiat Oncol Biol Phys, 2000 May 1

International journal of radiation oncology, biology, physics, 2016-10-01

Radiation oncology (London, England), 2012-07-11

CNS Oncol, 2016 Jul

N Engl J Med, 2007 Aug 16

J Clin Oncol, 1999 Jul

Lancet, 2015 Jan 3

International journal of radiation oncology, biology, physics, 2011-11-01

Int. J. Radiat. Oncol. Biol. Phys., 2006-09-01

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2017-12

Lancet Oncol., 2017-05-01

The New England journal of medicine, 1999-08-12

BMC Cancer, 2015-08-15

Journal of cancer research and therapeutics, 2012

International journal of radiation oncology, biology, physics, 2012-05-01

Neurosurgery, 2013-10

Practical radiation oncology, 2015

J. Neurosurg., 2005-01-01

J Korean Neurosurg Soc, 2011-08-01

Radiat Oncol, 2014-07-08

BMC Cancer, 2015-03-04

Acta Neurochir (Wien), 2013-01-01

The Lancet. Oncology, 2009-11

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2007-04-01

J Clin Oncol, 2011 Jan 10

JAMA, 2016-07-26

Radiation oncology (London, England), 2014-09-30

Cancer, 2016-06-15

J. Clin. Oncol., 2018 May 22

Lung cancer (Amsterdam, Netherlands), 2018-06

The New England journal of medicine, 2018-08-23

The New England journal of medicine, 2018-12-06

International journal of radiation oncology, biology, physics, 2019-04-01

Lancet, 2019 Oct 04

JAMA oncology, 2019-06-01

International journal of radiation oncology, biology, physics, 2019-04-01

International journal of radiation oncology, biology, physics, 2019-04-01

Neurosurgery, 2019 Oct 10

JAMA Oncol, 2020 Jun 4

J Clin Oncol, 2020 Aug 10

Lung Cancer, 2014 Aug 02

N Engl J Med,

Lancet Oncol, 2020 Apr 03

Int J Radiat Oncol Biol Phys,

JAMA,

J Neurosurg,

Cancer,

Int J Radiat Oncol Biol Phys, 2006 Dec 1

International journal of radiation oncology, biology, physics, 2010-03-01

International journal of radiation oncology, biology, physics, 2012-01-01

JAMA, 1998 Nov 4

Journal of neurosurgery, 2010-12

Lancet Oncol, 2014 Apr

J Neurosurg, 2014 Dec

Stereotactic and functional neurosurgery, 2017

Cancer treatment reviews, 2011-11

Practical radiation oncology, 2011

Stroke, 2008 Jul 17

J Neuroimaging, 2020 Feb 10

International journal of radiation oncology, biology, physics, 2018-03-15

International journal of radiation oncology, biology, physics, 2016-06-01

Int. J. Radiat. Oncol. Biol. Phys.,

Radiat Oncol, 2015 May 27

International journal of radiation oncology, biology, physics, 2016-06-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-04-01

The New England journal of medicine, 2016-11-10

The New England journal of medicine, 2018-01-11

N. Engl. J. Med.,

Radiat Oncol, 2011-05-15

International journal of radiation oncology, biology, physics, 2006-02-01

Int J Radiat Oncol Biol Phys, 2020 Sep 11

J Neuroophthalmol,

International journal of radiation oncology, biology, physics, 2016-06-01

Radiat Oncol, 2011-12-21

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011-08-01

Spine, 2010-10-15

Oncologist, 2017-08-01

Spine, 2016-10-15

International journal of radiation oncology, biology, physics, 2014-11-15

Int J Radiat Oncol Biol Phys, 2009 Sep 1

Journal of neurosurgery. Spine, 2012-07

International journal of radiation oncology, biology, physics, 2010-06-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-09-20

Future oncology (London, England), 2015

Future Oncol, 2015 Oct 15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-10-20

Int. J. Cancer, 2016 Jun 30

International journal of radiation oncology, biology, physics, 2017-05-01

The Lancet. Oncology, 2017-08

Neurology, 1989-06

Radiother Oncol, 2020 Jan

The Lancet. Oncology, 2016-07

J Thorac Oncol, 2019 Feb 16

Int. J. Radiat. Oncol. Biol. Phys., 2019 Aug 31

Lung Cancer, 2019 Jan 15

JAMA oncology, 2017-06-01

Neuro-oncology, 2019-02-23

Cureus, 2017 Dec 25

The spine journal : official journal of the North American Spine Society, 2017-10

Adv Radiat Oncol, 2021 May-Jun

Int J Radiat Oncol Biol Phys, 2019 Oct 10

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2021 May 05

International journal of radiation oncology, biology, physics, 2013-03-01

International journal of radiation oncology, biology, physics, 2020 Jan 24

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2001 Mar

Cancer research and treatment, 2006 Dec 31