Navigation Links
Stereotactic radiosurgery preferred method of treating cancer patients with brain metastases

HOUSTON Cancer patients who receive stereotactic radiosurgery (SRS) and whole brain radiation therapy (WBRT) for the treatment of metastatic brain tumors have more than twice the risk of developing learning and memory problems than those treated with SRS alone, according to researchers at The University of Texas M. D. Anderson Cancer Center.

The findings of the phase III randomized trial are published in the October 5, 2009 online edition of the Lancet Oncology. Led by Eric L. Chang, M.D., associate professor in the Department of Radiation Oncology at M. D. Anderson, the study supports the use of SRS alone combined with close monitoring as the initial treatment strategy for cancer patients newly diagnosed with one to three brain metastases.

"Though both approaches are equally acceptable and practiced in the United States, these findings allow radiation oncologists to recommend the optimal treatment for this group of patients," Chang said. "This method is consistent with the trend of personalized medicine and tailoring therapies, rather than applying the "one size fits all" approach of giving WBRT to all patients with brain metastases."

The American Cancer Society estimates approximately 170,000 cancer patients will experience metastases to the brain from common primary cancers such as breast, colorectal, kidney and lung in 2009. More than 80,000 of those patients will have between one and three brain metastases.

Over the last decade, SRS, which uses high-doses of targeted x-rays, has gained acceptance as an initial treatment for tumors that have spread to the brain. SRS is also commonly used in combination with WBRT, radiation of the entire brain, to treat tumors that are visible and those that may not be detected by diagnostic imaging.

The seven year study observed 58 patients presenting with one to three newly diagnosed brain metastases who were randomized to receive SRS followed by WBRT or SRS alone. Approximately four months after treatment, 52 percent of patients who received WBRT experienced a decline in learning and memory function compared with 24 percent in those patients who received SRS alone.

An independent data monitoring committee halted the trial after interim results showed the high statistical probability (96.4 percent) that patients randomized to SRS alone would continue to perform better.

M. D. Anderson researchers measured participants' neurocognitive function using a short battery of neuropsychological tests, with the primary endpoint being memory function as tested by the Hopkins Verbal Learning Test Revised. Patient performance that decreased more than a predefined criteria relative to their baseline were considered to exhibit a marked decline.

When researchers looked at progression-free survival, 73 percent patients who received SRS plus WBRT were free from recurrence at one year, compared with 27 percent of patients who received SRS. "Despite this difference in recurrence rates, we would still advise against WBRT because the risks of learning dysfunction outweigh the benefits of freedom from progression," said Chang. "With close monitoring, salvage resections or additional radiation can be performed as necessary and patients who receive SRS alone will fare better with their quality of life intact."

Although a secondary endpoint of the study, researchers found that the median one-year survival was higher for the SRS alone group than for patients assigned to SRS plus WBRT (15.2 vs. 5.7 months). Based on exploratory analysis, Chang and his team cite a possible explanation for this difference could be attributed to patients who received SRS alone were able to receive a median of two more chemotherapy cycles and get it one month sooner than those who received SRS plus WBRT.

"This treatment decision carries a lot of strong emotions on behalf of the patient and their physicians. In our practice at M. D. Anderson we've seen a clear preference toward SRS alone," Chang said. "Now we have the data to support this choice." Based on these results, future research studies are planned to determine if there are expanded indications of using SRS alone for patients with more than three brain metastases.


Contact: Lindsay Anderson
University of Texas M. D. Anderson Cancer Center

Related medicine news :

1. Lower-dose fractionated stereotactic radiotherapy results in better hearing preservation
2. Grupo IMO Hosts Symposium on Use of TomoTherapy for Stereotactic Radiosurgery and Stereotactic Body Radiation Procedures : Experts Detail HiArt Platform Advantages for Treatment of Brain, Lung, Pancreatic and Metastatic Cancers
3. BrainLAB Announces 510(k) FDA Clearance of Monte Carlo Dose Engine for Stereotactic Radiosurgery and Radiation Therapy
4. IAME Goes Live With New Stereotactic Breast Program
5. Florida Clinicians Now Delivering Non-Invasive Image-Guided Treatments Using Novalis Tx(TM) Radiosurgery Technology
6. Doctors at Banner Good Samaritan Medical Center Now Offering Precise Image-Guided Radiosurgery for Cancer and Neurological Disorders
7. Elekta Provides VMAT and Radiosurgery Solutions for New Jersey Health System
8. New Jersey Doctors Now Delivering Non-Invasive, Image-Guided Radiosurgery Treatments Using Novalis Tx(TM) Technology
9. Roswell Park Cancer Institute Leads Radiosurgery Capabilities in New York State with Leksell Gamma Knife Perfexion
10. Presentations at Leading Neurosurgery Meeting Highlight Benefits of CyberKnife Radiosurgery for the Treatment of CNS Indications
11. Elekta Radiosurgery Solutions are Creating New Possibilities for the Most Challenging Cases of the Head And Body
Post Your Comments:
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... A recent ... that most people are unfamiliar with. The article goes on to state that individuals ... also many of these less common operations such as calf and cheek reduction. The ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... June 19, ... the dangers associated with chronic pain and the benefits of holistic treatments, Serenity ... who are suffering with Sickle Cell Disease. , Sickle Cell Disease (SCD) is a ...
(Date:6/24/2016)... Dallas, Texas (PRWEB) , ... June 24, 2016 ... ... 12th International Conference and Scientific Sessions in Dallas that it will receive two ... Announcement of the grants came as PHA marked its 25th anniversary by recognizing ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. ... accelerated orthodontic treatment. Dr. Cheng has extensive experience with all areas of orthodontics, ... and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic ...
(Date:6/24/2016)... ... ... Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ‘Business for a Fair ... hour by 2020 and then adjusting it yearly to increase at the same rate as ... the wage floor does not erode again, and make future increases more predictable. , The ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 24, 2016 The Academy of Managed Care ... that would allow biopharmaceutical companies to more easily ... make formulary and coverage decisions, a move that addresses ... medicines. The recommendations address restrictions in the ... the drug label, a prohibition that hinders decision makers ...
(Date:6/24/2016)... -- Research and Markets has announced the addition ... report to their offering. ... The World Market for Companion Diagnostics covers the world ... in the report includes the following: , ... by Region (N. America, EU, ROW), 2015-2020 , World ...
(Date:6/24/2016)... Belgium , June 24, 2016 /PRNewswire/ ... announced the appointment of Dr. Edward Futcher ... a Non-Executive Director, effective June 23, 2016.Dr. Futcher ... and Nominations and Governance Committees.  As a non-executive ... provide independent expertise and strategic counsel to VolitionRx ...
Breaking Medicine Technology: