Researchers recommend standard treatment with monitoring over whole-brain radiotherapy
MONDAY, Oct. 5 (HealthDay News) -- Brain tumor patients experience more learning and memory problems when whole-brain radiation therapy (WBRT) is added to standard stereotactic radiosurgery (SRS), researchers have found.
SRS delivers narrowly focused beams of radiation to the tumor site.
The study included 58 patients with one to three newly diagnosed brain metastases who were randomly selected to receive SRS alone (30 patients) or SRS plus WBRT (28 patients). However, the trial was halted early because there was a 96 percent probability that patients in the SRS/WBRT group were significantly more likely to experience declines in memory and function after four months than those receiving SRS alone.
After four months, there were four deaths (13 percent) in the patients who received SRS alone and eight deaths (29 percent) in the SRS/WBRT group, the study authors reported. After one year, 73 percent of patients in the SRS/WBRT group were recurrence-free, compared with 27 percent of patients who received SRS alone.
Despite the better outcomes among patients in the SRS/WBRT group, the researchers advised against the use of WBRT because it causes a greater decline in brain function. When brain tumors recur, they can be managed effectively with surgery if they're spotted early through regular monitoring.
"Applicability of the findings is dependent on the willingness of patients and their physicians to adhere to a schedule of close monitoring, having consistent access to high-quality MRI, having access to a neurosurgical team willing and able to perform salvage resections when indicated, and applying strict physics quality-assurance procedures for SRS," wrote Dr. Eric L. Chang, of the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues.
"This study provides level 1 evidence to support the use of SRS alone in the initial management of patients newly diagnosed with one to three brain metastases. We recommend that initial SRS alone combined with close clinical monitoring should be the preferred treatment strategy for such patients," they concluded.
The study appears online and in the November print issue of The Lancet Oncology.
The U.S. National Cancer Institute has more about brain tumors.
-- Robert Preidt
SOURCE: The Lancet Oncology, news release, Oct. 4, 2009
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