248 / 1578
/
Ø
Adverse effect of WBI on neurocognitive fraction already
after 3 months
Brain metastases
NCCTG N0574 (Alliance): A phase III randomized trial of whole brain radiation
therapy (WBRT) in addition to radiosurgery (SRS) in patients with 1 to 3 brain
metastases
Brown ASCO 2015
Cognitive function
deterioration
@ 3 months
SRS
SRS + WBI
immediate recall
8%
31%
delayed recall
20%
51%
verbal fluency
2%
19%
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/
• Conventional radiotherapy = Short term palliation
Ø
Patients with better OS will develop pain recurrence
Palliative RT Pain response
Duration
Prince
1986
1 x 8Gy
10 x 3Gy
73%
64%
59% @ 3 mo
50% @ 3 mo
Gaze
1997
1 x 10Gy
5 x 4.5Gy
84%
89%
Median 3.5 mo
Median 3.5 mo
Steenland
1999
1 x 8Gy
6 x 4Gy
72%
69%
Median 5 mo
Median 6 mo
Roos
2005
1 x 8Gy
5 x 4Gy
61%
53%
Median 3.5mo
Median 5.5 mo
Painful bone / vertebral metastases
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