(HealthDay News) — In a clinical practice guideline issued by the American Society for Radiation Oncology and published online May 6 in Practical Radiation Oncology, updated recommendations are presented regarding the use of radiation for treating brain metastases.
Vinai Gondi, MD, from the Northwestern Medicine Cancer Center and Proton Center in Warrenville, Illinois, and colleagues updated evidence-based recommendations addressing recent developments in the management of patients with brain metastases.
The researchers found that for patients with limited brain metastases and Eastern Cooperative Oncology Group performance status 0 to 2, stereotactic radiosurgery (SRS) is strongly recommended. For all tumors causing mass effect and/or that are greater than 4 cm, multidisciplinary discussion with neurosurgery is conditionally recommended to consider surgical resection. Upfront local therapy is strongly recommended for patients with symptomatic brain metastases. Multidisciplinary and patient-centered decision-making to determine whether local therapy may be safely deferred is conditionally recommended for patients with asymptomatic brain metastases who are eligible for central nervous system-active systemic therapy. To improve local control, SRS is strongly recommended for patients with resected brain metastases. Early introduction of palliative care for symptom management and caregiver support are strongly recommended for patients with poor prognosis.
“With the emergence of novel radiotherapy techniques and technologies, brain-penetrating drug therapies and neurosurgical interventions, modern management of brain metastases has become increasingly personalized, complex, and multidisciplinary,” Gondi said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry.