Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology.
Brain metastases
Management of brain metastases
Multiple brain metastases
Pattern of care
Radiosurgery
Stereotactic radiotherapy
Journal
Journal of neuro-oncology
ISSN: 1573-7373
Titre abrégé: J Neurooncol
Pays: United States
ID NLM: 8309335
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
29
11
2020
accepted:
06
02
2021
pubmed:
24
2
2021
medline:
17
11
2021
entrez:
23
2
2021
Statut:
ppublish
Résumé
The treatment of brain metastases (BM) has changed considerably in recent years and in particular, the management of multiple BM is currently undergoing a paradigm shift and treatment may differ from current guidelines. This survey was designed to analyze the patterns of care in the management of multiple BM. An online survey consisting of 36 questions was distributed to the members of the German Society for Radiation Oncology (DEGRO). In total, 193 physicians out of 111 institutions within the German Society for Radiation oncology responded to the survey. Prognostic scores for decision making were not used regularly. Whole brain radiotherapy approaches (WBRT) are the preferred treatment option for patients with multiple BM, although stereotactic radiotherapy treatments are chosen by one third depending on prognostic scores and overall number of BM. Routine hippocampal avoidance (HA) in WBRT is only used by a minority. In multiple BM of driver-mutated non-small cell lung cancer origin up to 30% favor sole TKI therapy as upfront treatment and would defer upfront radiotherapy. In multiple BM WBRT without hippocampal avoidance is still the preferred treatment modality of choice regardless of GPA and mutational status, while SRT is only used in patients with good prognosis. Evidence for both, SRS and hippocampal avoidance radiotherapy, is growing albeit the debate over the appropriate treatment in multiple BM is yet not fully clarified. Further prospective assessment of BM management-ideally as randomized trials-is required to align evolving concepts with the proper evidence and to update current guidelines.
Identifiants
pubmed: 33620657
doi: 10.1007/s11060-021-03714-w
pii: 10.1007/s11060-021-03714-w
pmc: PMC7997832
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
395-404Références
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