Topics:
Radiation Oncology • Stereotactic Radiosurgery
Is there any role for SRS+WBRT for patients with a limited number of small brain metastases?
In keeping with prior randomized trials, Alliance N0574 demonstrated that SRS+WBRT provides superior intracranial disease control but worsens QOL and neurocognitive abilities, without improving survival, compared to SRS alone for patients with good performance status and 1-3 brain metastases, none larger than 3 cm in max diameter. Should SRS+WBRT still be considered for patients with high DS-GPA, as suggested by a post-hoc analysis of JROSG 99-1, or in patients who may not adhere to the close surveillance regimen used in Alliance N0574?
Answer from: Radiation Oncologist at Academic Institution
The recent publication from Dr Brown confirmed the finding from prior studies, that omitting upfront whole brain RT doesn't compromise OS in patients with limited brain metastases. More importantly, this second study had neurocognition as the primary end point, and confirmed better neurocognition pr...
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