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Review
. 2018 Feb 10;36(5):483-491.
doi: 10.1200/JCO.2017.75.9589. Epub 2017 Dec 22.

Whole-Brain Radiotherapy for Brain Metastases: Evolution or Revolution?

Paul D Brown  1 , Manmeet S Ahluwalia  1 , Osaama H Khan  1 , Anthony L Asher  1 , Jeffrey S Wefel  1 , Vinai Gondi  1
Affiliations
Review

Whole-Brain Radiotherapy for Brain Metastases: Evolution or Revolution?

Paul D Brown et al. J Clin Oncol. .

Abstract

An estimated 20% of patients with cancer will develop brain metastases. Approximately 200,000 individuals in the United States alone receive whole-brain radiotherapy (WBRT) each year to treat brain metastases. Historically, the prognosis of patients with brain metastases has been poor; however, with new therapies, this is changing. Because patients are living longer following the diagnosis and treatment of brain metastases, there has been rising concern about treatment-related toxicities associated with WBRT, including neurocognitive toxicity. In addition, recent clinical trials have raised questions about the use of WBRT. To better understand this rapidly changing landscape, this review outlines the treatment roles and toxicities of WBRT and alternative therapies for the management of brain metastases.

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Figures

Fig 1.
Fig 1.
Tumor treating fields are administered by four transducer arrays placed on the shaved scalp and connected to a portable device.
Fig 2.
Fig 2.
(A) The hippocampal avoidance region (blue) is generated by expanding the hippocampal contour (orange) by 5 mm. (B) Color wash dose distributions for hippocampal-avoidance whole-brain radiotherapy are shown on representative axial, sagittal, and coronal images.
See this image and copyright information in PMC

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