Updated Guidelines Shed Light on Using Radiation A
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The American Society for Radiation Oncology recently released a new clinical guideline that offers guidance on how radiation therapy should be used when treating brain metastases. Brain metastases are tumors that develop when cancer cells from a primary tumor located in another part of the body — mostly melanoma, breast cancer or lung cancer — spread to a patient’s brain.
These tumors develop in about 40% of individuals who have already been diagnosed with cancer, with almost 200,000 new cases being diagnosed annually in America. Radiation therapy is usually used to manage these brain tumors, providing patients relief from dizziness, headaches and other neurological issues caused by the tumors. This therapy also prolongs their survival.
To preserve the quality of the life of patients and decrease the therapy’s adverse effects, scientists have developed advanced radiation therapy methods including hippocampal avoidance, whole-brain radiation therapy and stereotactic radiosurgery, which have fewer side effects. These techniques limit exposure to healthy brain tissue while delivering radiation to the tumors.
Experts advise against the use of whole-brain radiation except in specific cases, as it has been linked to cognitive deterioration.
The multidisciplinary planning and delivery of these advanced radiation therapy methods for the management of resected and intact brain metastases is guided by evidence-based recommendations. These recommendations also address patient selection as well as the evaluation of treatment algorithms for extensive brain metastases and limited brain metastases.
For resected brain tumors, the guideline task force recommends that radiation therapy be administered to all patients whose metastases have been resected to improve intracranial control. It also recommends that postoperative stereotactic surgery be performed for patients with limited brain metastases following resection to help preserve their quality of lives as well as their cognitive functions. The task force notes that stereotactic radiosurgery being performed before metastasis resection could be an alternative to postoperative stereotactic radiosurgery.
The task force also recommends upfront local therapy for patients with unresected and symptomatic brain tumors. In addition to this, it recommends stereotactic radiosurgery for patients with no more than four brain tumors, noting that patients with larger-size tumors may need to consider surgical resection.
Furthermore, it advises that patients with poor prognosis look into options such as short-course whole brain radiation therapy for symptomatic brain metastases, hospice or palliative care, noting that whole-brain radiation therapy may not improve their outcomes.
The task force highlights that factors such as tumor location, volume, extracranial illness status and age be considered when making decisions on whether to administer stereotactic radiosurgery.
The recently released guideline updates the society’s 2012 guideline and was published in “Practical Radiation Oncology.”
Given that many patients don’t respond well to the existing brain cancer treatments, entities such as CNS Pharmaceuticals Inc. (NASDAQ: CNSP) have been driven to search for the next generation of therapies that will produce better results and have a superior safety profile.
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