Abstract
Background. This review article summarizes the contemporary standard of fractionated external beam radiation therapy in the management of brain metastases. Material and methods. The results of meta-analyses, randomized studies and prospective cohort studies were analyzed with emphasis on the role of whole-brain irradiation (WBI). Results. For patients with 1-3 brain metastases, local therapy (radiosurgery or resection) is the treatment of choice. Additional WBI improves intracranial control without impacting on overall survival (level of evidence LoE I). The highest risk of recurrence is after resection of metastases without additional radiotherapy and adjuvant local radiotherapy of the resection cavity has demonstrated high local control rates (LoE II). For patients with multiple (more than three) metastases WBI is the only modality with a proven impact on survival (LoE I). For patients with a very poor prognosis, short-term radiotherapy regimens are recommended and additional systemic therapy does not improve survival (LoE I). Protection of brain function with modern radiotherapy techniques (sparing of the hippocampus) seems to be feasible and effective and is currently under investigation. Conclusions. For patients with multiple brain metastases (n ≥ 4) fractionated WBI remains the standard of care.
| Translated title of the contribution | Brain metastases. Conventional radiation therapy |
|---|---|
| Original language | German |
| Journal | Onkologe |
| Volume | 20 |
| Issue number | 1 |
| Pages (from-to) | 45-49 |
| Number of pages | 5 |
| ISSN | 0947-8965 |
| DOIs | |
| Publication status | Published - 01.2014 |
