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Adding whole-brain radiotherapy to focused radiosurgery for a few brain metastases caused more memory and thinking problems without lengthening life, so radiosurgery alone became standard for limited brain metastases.
Phase 3 trial of 213 patients with one to three brain metastases randomised to stereotactic radiosurgery alone or radiosurgery plus whole-brain radiotherapy, with cognitive decline at three months as the primary endpoint.
Cognitive deterioration was more frequent with whole-brain radiotherapy (91.7 versus 63.5 percent) despite better intracranial control, and median overall survival did not differ (10.4 versus 7.4 months, not significant).
Patients with a limited number of brain metastases are treated with radiosurgery alone and surveillance, accepting more new brain lesions in return for preserved cognition.
Shares Paul D. Brown, Brain metastases (secondary brain tumours).
Shares Paul D. Brown, Brain metastases (secondary brain tumours).
Shares Alliance N0574 (NCCTG N0574), Brain metastases (secondary brain tumours).
Shares Alliance N0574 (NCCTG N0574), Brain metastases (secondary brain tumours).
Shares Alliance N0574 (NCCTG N0574), Brain metastases (secondary brain tumours).