How do you manage multiple brain metastases from small cell lung cancer?
Do you have a number/volume threshold for SRS vs WBRT?
Answer from: Radiation Oncologist at Academic Institution
In general, I think WBRT is a reasonable treatment for small-cell lung cancer (SCLC) brain metastases. That being said, our institution has considered SRS for select patients depending on a variety of factors as the treatment paradigm for this is evolving. There have been some studies addressing SRS...
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Answer from: at Academic Institution
In our precedent study to FIRE-SCLC that looked at SRS salvage following WBRT and SRS alone (Cifarelli et al., PMID 31599324), we reported a median number of mets treated as 2 with an IQR:[1-5]. "On univariate analysis, the only factor significantly associated with distant brain control was num...
Answer from: Radiation Oncologist at Academic Institution
Distant failure for SRS vs WBRT for some defined number of brain mets in SCLC may not be the sole appropriate goal. Endpoints should include duration of functional independence, harm from re-treatment with SRS salvage for the SRS and WBRT arm (not common), harm from WBRT including worsening fatigue,...
Answer from: Radiation Oncologist at Community Practice
Personal and institution experience.
Comments
Radiation Oncologist at Ashland Radiation Oncology, Inc.
I recently had a patient with small cell lung canc...
I recently had a patient with small cell lung canc...
Radiation Oncologist at West Virginia University
One option would be to offer WBI with hippocampal ...
One option would be to offer WBI with hippocampal ...