Shyam Tanguturi1, Laura E G Warren2. 1. Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, 75 Francis Street, ASB1, L2, Boston, MA, 02115, USA. 2. Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, 75 Francis Street, ASB1, L2, Boston, MA, 02115, USA. lewarren@partners.org.
Abstract
PURPOSE OF REVIEW: For patients with breast cancer who develop brain metastases, radiation therapy (RT) provides local control. Here, we review the current role for central nervous system RT, particularly focusing on the evolving role for stereotactic radiosurgery (SRS). RECENT FINDINGS: SRS treats only known CNS disease as opposed to whole-brain radiation therapy (WBRT), which treats the entire brain parenchyma. SRS has been found to cause less neurocognitive decline than WBRT. SRS is currently utilized in patients with four or fewer brain metastases, but several ongoing trials are examining the use of SRS for greater than four metastases. For patients requiring WBRT, hippocampal avoidance WBRT and memantine concurrent with and adjuvant to WBRT have been found to reduce the risk of neurocognitive decline. Both SRS and WBRT are used as a local therapy for brain metastases. SRS is increasingly preferred given fewer long-term neurocognitive side effects.
PURPOSE OF REVIEW: For patients with breast cancer who develop brain metastases, radiation therapy (RT) provides local control. Here, we review the current role for central nervous system RT, particularly focusing on the evolving role for stereotactic radiosurgery (SRS). RECENT FINDINGS:SRS treats only known CNS disease as opposed to whole-brain radiation therapy (WBRT), which treats the entire brain parenchyma. SRS has been found to cause less neurocognitive decline than WBRT. SRS is currently utilized in patients with four or fewer brain metastases, but several ongoing trials are examining the use of SRS for greater than four metastases. For patients requiring WBRT, hippocampal avoidance WBRT and memantine concurrent with and adjuvant to WBRT have been found to reduce the risk of neurocognitive decline. Both SRS and WBRT are used as a local therapy for brain metastases. SRS is increasingly preferred given fewer long-term neurocognitive side effects.
Entities:
Keywords:
Brain metastases; Breast cancer; Central nervous system metastases; Neurocognition; Radiation therapy; Radiosurgery; SRS; Side effects; Stereotactic radiation; Whole-brain radiation
Authors: Ashraf S Mahmoud-Ahmed; John H Suh; Shih-Yuan Lee; Richard L Crownover; Gene H Barnett Journal: Int J Radiat Oncol Biol Phys Date: 2002-11-01 Impact factor: 7.038
Authors: Jill S Barnholtz-Sloan; Andrew E Sloan; Faith G Davis; Fawn D Vigneau; Ping Lai; Raymond E Sawaya Journal: J Clin Oncol Date: 2004-07-15 Impact factor: 44.544
Authors: Johanna C Bendell; Susan M Domchek; Harold J Burstein; Lyndsay Harris; Jerry Younger; Irene Kuter; Craig Bunnell; Montse Rue; Rebecca Gelman; Eric Winer Journal: Cancer Date: 2003-06-15 Impact factor: 6.860
Authors: Minesh P Mehta; Patrick Rodrigus; C H J Terhaard; Aroor Rao; John Suh; Wilson Roa; Luis Souhami; Andrea Bezjak; Mark Leibenhaut; Ritsuko Komaki; Christopher Schultz; Robert Timmerman; Walter Curran; Jennifer Smith; See-Chun Phan; Richard A Miller; Markus F Renschler Journal: J Clin Oncol Date: 2003-07-01 Impact factor: 44.544
Authors: A J Clayton; S Danson; S Jolly; W D J Ryder; P A Burt; A L Stewart; P M Wilkinson; R S Welch; B Magee; G Wilson; A Howell; A M Wardley Journal: Br J Cancer Date: 2004-08-16 Impact factor: 7.640