Whole brain radiotherapy

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Whole brain radiotherapy
Specialty Oncology

Whole brain radiotherapy (WBRT) is a treatment option for patients with brain metastases. In WBRT, radiation therapy is administered broadly, to the whole brain, over multiple treatments. [1]

Usage

WBRT has been shown to alleviate symptoms, decrease the use of corticosteroids needed to control tumor-associated edema, and potentially improve overall survival. [2] However, WBRT has been reported to increase the risk of cognitive decline. [3] However, single trials suggest that WBRT with memantine or hippocampal sparing may delay cognitive decline, though these methods did not improve survival or quality of life. [4]

WBRT may be administered in combination with stereotactic radiosurgery (SRS), surgery, or systemic therapies. [1] Based on data, WBRT combined with systemic therapies increased the likelihood of vomiting but overall, there were no other major differences regarding adverse events between these two treatment methods. [5] Memantine has been recommended for use by professional organization consensus to prevent neurocognitive decline after WBRT. [6] While these can improve survival for some patients with single brain metastasis, a 2021 systematic review of the literature found inconsistent results for overall survival. [1]

References

  1. 1 2 3 Garsa A, Jang JK, Baxi S, Chen C, Akinniranye O, Hall O, et al. (2021). "Radiation Therapy for Brain Metastases". Effective Health Care (EHC) Program. Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health & Human Services. doi:10.23970/ahrqepccer242. PMID   34152714. S2CID   236256085.
  2. ↑ McTyre E, Scott J, Chinnaiyan P (2013). "Whole brain radiotherapy for brain metastasis". Surgical Neurology International. 4 (Suppl 4): S236 –S244. doi: 10.4103/2152-7806.111301 . PMC   3656558 . PMID   23717795.
  3. ↑ Johnson K (June 2015). "Whole-Brain Radiotherapy: Risks Worth Benefit?". Medscape.com. Retrieved August 20, 2015.
  4. ↑ Garsa A, Jang JK, Baxi S, Chen C, Akinniranye O, Hall O, et al. (2021-06-09). Radiation Therapy for Brain Metasases (Report). Agency for Healthcare Research and Quality (AHRQ). doi:10.23970/ahrqepccer242.
  5. ↑ Garsa A, Jang JK, Baxi S, Chen C, Akinniranye O, Hall O, et al. (2021-06-09). Radiation Therapy for Brain Metasases (Report). Agency for Healthcare Research and Quality (AHRQ). doi:10.23970/ahrqepccer242.
  6. ↑ Vogelbaum MA, Brown PD, Messersmith H, Brastianos PK, Burri S, Cahill D, et al. (February 2022). "Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline". Journal of Clinical Oncology. 40 (5): 492–516. doi: 10.1200/JCO.21.02314 . PMID   34932393. S2CID   245385315.
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