Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Role of Chemotherapy in the Management of Adults With Newly Diagnosed Metastatic Brain Tumors. Issue 3 (9th January 2019)

• Record Type: Journal Article
• Authors: Sherman, Jonathan H; Lo, Simon S; Harrod, Tom; Hdeib, Alia; Li, Yiping; Ryken, Timothy; Olson, Jeffrey J
• Is Part Of: Neurosurgery. Volume 84:Issue 3(2019)
• Page Start: E175
• Page End: E177
• Publication Date: 2019-01-09
• Subjects: Brain metastases -- Cerebral metastases -- Chemotherapy -- Practice guideline -- Stereotactic radiosurgery -- Systematic review -- Whole brain radiation therapy; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyy544
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: QUESTION 1: Should patients with brain metastases receive chemotherapy in addition to whole brain radiotherapy (WBRT) for the treatment of their brain metastases? TARGET POPULATION: This recommendation applies to adult patients with newly diagnosed brain metastases amenable to both chemotherapy and radiation treatment. RECOMMENDATIONS: Level 1: Routine use of chemotherapy following WBRT for brain metastases is not recommended. Level 3: Routine use of WBRT plus temozolomide is recommended as a treatment for patients with triple negative breast cancer. QUESTION 2: Should patients with brain metastases receive chemotherapy in addition to stereotactic radiosurgery (SRS) for the treatment of their brain metastases? RECOMMENDATIONS: Level 1: Routine use of chemotherapy following SRS is not recommended. Level 2 : SRS is recommended in combination with chemotherapy to improve overall survival and progression free survival in lung adenocarcinoma patients. QUESTION 3: Should patients with brain metastases receive chemotherapy alone? RECOMMENDATION: Level 1: Routine use of cytotoxic chemotherapy alone for brain metastases is not recommended as it has not been shown to increase overall survival. Please see the full-text version of this guideline (https://www.cns.org/guidelines/guidelines-treatment-adults-metastatic-brain-tumors/chapter_5 ) for the target population of each recommendation.