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Radiotherapeutic and surgical management for newly diagnosed brain metastasis/es: An American Society for Radiation Oncology evidence-based guideline (2012)

Authors: May N. Tsao, MD, Dirk Rades, MD, Andrew Wirth, MD, Simon S. Lo, MD, Brita L. Danielson, MD, Laurie E. Gaspar, MD, MBA, Paul W. Sperduto, MD, MPP,Michael A. Vogelbaum, MD, PhD, Jeffrey D. Radawski, MD, Jian Z. Wang, PhD, Michael T. Gillin, PhD, Najeeb Mohideen, MD, Carol A. Hahn, MD, and Eric L. Chang, MD 

This guideline provides guidance for patients and physicians regarding the following key clinical questions: What prognostic factors are important for assessing and managing patients with newly diagnosed brain metastases; for patients with single brain metastasis (excluding radiosensitive histologies such as small cell lung cancer, leukemia, lymphoma and germ cell tumor), does surgical resection and whole brain radiotherapy improve survival or brain control compared with whole brain radiotherapy alone or surgical resection alone; is survival or brain control different in selected patients with single brain metastasis (excluding radiosensitive histologies such as small cell lung cancer, leukemia, lymphoma and germ cell tumor) treated with surgery or radiosurgery; is there a survival or brain control difference in patients treated with WBRT and radiosurgery boost versus WBRT alone; is there a difference in survival, brain control or neurocognitive outcomes in patients treated with radiosurgery alone versus WBRT and radiosurgery; what is the role of comfort measures or palliative supportive care alone versus WBRT in patients with multiple brain metastases; what is the optimal WBRT dose fractionation schedule; what is the role of radiosensitizers with WBRT in the management of patients with brain metastases; and what is the role of chemotherapy and WBRT? 

Read the guideline.

Content last updated 1/10/2014
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