Skip to main content
SpringerLink
Log in

Whole Brain Radiotherapy (WBRT) for Brain Metastases

  • Chapter
  • First Online:
Central Nervous System Metastases

  • 956 Accesses

Abstract

WBRT was the historical reference in the management of metastatic patients with brain metastases (BMs) both acting as a palliative tool for symptomatic patients and also by effectively preventing the risk of developing new BMs, including the postoperative setting [1]. To be noted and until the early 2000s, median overall survival (OS) of these patients was usually between 6 and 9 months, and consequently neurocognitive status and quality of life were evaluated with ‘basic’ tools such as the Karnofsky Performance Status (KPS), the MMSE (Mini-Mental Status Exam) or the EORTC QLQ (Quality of Life Questionnaire)-Brain Neurologic (BN-20) module, also due to the lack of time devoted to this clearly ‘palliative’ care.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tsao MN, Xu W, Wong RK, et al. Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases. Cochrane Database Syst Rev. 2018;1:CD003869.

    Google Scholar 

  2. DeAngelis LM, Delattre JY, Posner JB. Radiation-induced dementia in patients cured of brain metastases. Neurology. 1989;39(6):789–96.

    Article  CAS  Google Scholar 

  3. Dhermain F, Barani IJ. Complications from radiotherapy. Handb Clin Neurol. 2016;134:219–34.

    Article  Google Scholar 

  4. Sun A, Bae K, Gore EM, et al. Phase III trial of prophylactic cranial irradiation compared with observation in patients with locally advanced non-small-cell lung cancer: neurocognitive and quality-of-life analysis. J Clin Oncol. 2011;29(3):279–86.

    Article  Google Scholar 

  5. De Ruysscher D, Dingemans AC, Praag J, et al. Prophylactic cranial irradiation versus observation in radically treated stage III non-small-cell lung cancer: a randomized phase III NVALT-11/DLCRG-02 study. J Clin Oncol. 2018;36(23):2366–77.

    Article  Google Scholar 

  6. Aupérin A, Arriagada R, Pignon JP, et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group. N Engl J Med. 1999;341(7):476–84.

    Google Scholar 

  7. Slotman B, Faivre-Finn C, Kramer G, et al.; EORTC Radiation Oncology Group and Lung Cancer Group. Prophylactic cranial irradiation in extensive small-cell lung cancer. N Engl J Med 2007;357(7):664-672

    Article  CAS  Google Scholar 

  8. Takahashi T, Yamanaka T, Seto T, et al. Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2017;18(5):663–71.

    Article  Google Scholar 

  9. Bernhardt D, Hommertgen A, Schmitt D, et al. Whole brain radiation therapy alone versus radiosurgery for patients with 1-10 brain metastases from small cell lung cancer (ENCEPHALON Trial): study protocol for a randomized controlled trial. Trials. 2018;19(1):388.

    Article  Google Scholar 

  10. Andrews DW, Scott CB, Sperduto PW, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet. 2004;363(9422):1665–72.

    Article  Google Scholar 

  11. Chang EL, Wefel JS, Hess KR, et al. Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol. 2009;10(11):1037–44.

    Article  Google Scholar 

  12. Soffietti R, Kocher M, Abacioglu UM, et al. A European Organisation for Research and Treatment of Cancer phase III trial of adjuvant whole-brain radiotherapy versus observation in patients with one to three brain metastases from solid tumors after surgical resection or radiosurgery: quality-of-life results. J Clin Oncol. 2013;31(1):65–72.

    Article  Google Scholar 

  13. Brown PD, Jaeckle K, Ballman KV, et al. Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. JAMA. 2016;316(4):401–9.

    Article  Google Scholar 

  14. Brown PD, Ballman KV, Cerhan JH, et al. Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC·3): a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18(8):1049–60.

    Article  Google Scholar 

  15. Kayama T, Sato S, Sakurada K, et al; Japan Clinical Oncology Group. Effects of surgery with salvage stereotactic radiosurgery versus surgery with whole-brain radiation therapy in patients with one to four brain metastases (JCOG0504): a phase III, noninferiority, randomized controlled trial. J Clin Oncol 2018:JCO2018786186

    Google Scholar 

  16. Mulvenna P, Nankivell M, Barton R, et al. Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): results from a phase 3, non-inferiority, randomised trial. Lancet. 2016;388(10055):2004–14.

    Article  CAS  Google Scholar 

  17. Pechoux CL, Dhermain F, Besse B. Whole brain radiotherapy in patients with NSCLC and brain metastases. Lancet. 2016;388(10055):1960–2.

    Article  Google Scholar 

  18. Yamamoto M, Serizawa T, Shuto T, et al. Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol. 2014;15(4):387–95.

    Article  Google Scholar 

  19. Brown PD, Pugh S, Laack NN, et al; Radiation Therapy Oncology Group (RTOG). Memantine for the prevention of cognitive dysfunction in patients receiving whole-brain radiotherapy: a randomized, double-blind, placebo-controlled trial. Neuro Oncol 2013;15(10):1429-1437.

    Google Scholar 

  20. Gondi V, Pugh SL, Tome WA, et al. Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases. J Clin Oncol. 2014;32(34):3810–6.

    Article  Google Scholar 

  21. Peiffer AM, Leyrer CM, Greene-Schloesser DM, et al. Neuroanatomical target theory as a predictive model for radiation-induced cognitive decline. Neurology. 2013;80(8):747–53.

    Article  Google Scholar 

  22. Farris M, McTyre ER, Cramer CK, et al. Brain metastasis velocity: a novel prognostic metric predictive of overall survival and freedom from whole-brain radiation therapy after distant brain failure following upfront radiosurgery alone. Int J Radiat Oncol Biol Phys. 2017;98(1):131–41.

    Article  Google Scholar 

  23. Le Rhun E, Dhermain F, Vogin G, et al. Radionecrosis after stereotactic radiotherapy for brain metastases. Expert Rev Neurother. 2016;16(8):903–14.

    Article  Google Scholar 

  24. Zindler JD, Slotman BJ, Lagerwaard FJ. Patterns of distant brain recurrences after radiosurgery alone for newly diagnosed brain metastases: implications for salvage therapy. Radiother Oncol. 2014;112(2):212–6.

    Article  Google Scholar 

  25. Nieder C, Mehta MP, Geinitz H, et al. Prognostic and predictive factors in patients with brain metastases from solid tumors: a review of published nomograms. Crit Rev Oncol Hematol. 2018;126:13–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Institut Gustave Roussy, University Hospital, Villejuif, France

    Frédéric Dhermain

Authors
  1. Frédéric Dhermain
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Frédéric Dhermain .

Editor information

Editors and Affiliations

  1. Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

    Manmeet Ahluwalia

  2. Department of Neurosurgery and Neuro-Oncology, Clairval Hospital Center, Ramsay-Générale de Santé, Marseille, France, Neurophysiopathology Institute, Aix-Marseille Université, Marseille, France

    Philippe Metellus

  3. Department of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy

    Riccardo Soffietti

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dhermain, F. (2020). Whole Brain Radiotherapy (WBRT) for Brain Metastases. In: Ahluwalia, M., Metellus, P., Soffietti, R. (eds) Central Nervous System Metastases. Springer, Cham. https://doi.org/10.1007/978-3-030-23417-1_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-23417-1_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-23416-4

  • Online ISBN: 978-3-030-23417-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation