Medicine:Whole brain radiotherapy

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Short description: Treatment for cancer in the brain

Whole brain radiotherapy
Specialtyoncology

Whole brain radiotherapy (WBRT) is a treatment option for patients with brain metastases. In WBRT, radiation therapy is administered broadly, to the whole brain, over multiple treatments.[1] Another type of WBRT is Hippocampal-avoidance whole brain radiotherapy (HA-WBRT).[2] HA-WBRT is an altered version of WBRT, where it is highly selective as to where the radiation dose is delivered by treating the whole brain while reducing the amount on the hippocampus.[3]

Usage

WBRT has been shown to alleviate symptoms, decrease the use of corticosteroids needed to control tumor-associated edema, and potentially improve overall survival.[4] However, WBRT has been reported to increase the risk of cognitive decline.[5] However, single trials suggest that WBRT with memantine or hippocampal sparing may delay cognitive decline, though these methods did not improve survival or quality of life.[6]

WBRT may be administered in combination with stereotactic radiosurgery (SRS), surgery, or systemic therapies.[1] Based on data, WBRT combined with systemic therapies increased the likelihood of vomiting but overall, there were no other major differences regarding adverse events between these two treatment methods.[7] Memantine has been recommended for use by professional organization consensus to prevent neurocognitive decline after WBRT.[8] While these can improve survival for some patients with single brain metastasis, a 2021 systematic review of the literature found inconsistent results for overall survival.[1]

References

  1. ↑ 1.0 1.1 1.2 "Radiation Therapy for Brain Metastases". Effective Health Care (EHC) Program (Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health & Human Services). 2021. doi:10.23970/ahrqepccer242. PMID 34152714. 
  2. ↑ Woods, Kaley; Shen, Zhilei Liu; Xu, Zhengzheng; Zhang, Hualin; Natsuaki, Yutaka; Cheng, Karen; Li, Vivian; Kim, Nathan et al. (2023-10-31). "Hippocampal sparing radiation therapy for brain metastases: treatment techniques and clinical implementation" (in en). Chinese Clinical Oncology 12 (5): 56. doi:10.21037/cco-23-73. ISSN 2304-3873. PMID 37964545. https://cco.amegroups.org/article/view/118549. 
  3. ↑ Garsa, Adam; Jang, Julie K.; Baxi, Sangita; Chen, Christine; Akinniranye, Olamigoke; Hall, Owen; Larkin, Jody; Motala, Aneesa et al. (2021-06-09). Radiation Therapy for Brain Metasases (Report). Agency for Healthcare Research and Quality (AHRQ). doi:10.23970/ahrqepccer242. https://effectivehealthcare.ahrq.gov/products/radiation-therapy-brain-metastases/research. 
  4. ↑ "Whole brain radiotherapy for brain metastasis". Surgical Neurology International 4 (Suppl 4): S236–S244. 2013. doi:10.4103/2152-7806.111301. PMID 23717795. 
  5. ↑ "Whole-Brain Radiotherapy: Risks Worth Benefit?". June 2015. http://www.medscape.com/viewarticle/845758. 
  6. ↑ Garsa, Adam; Jang, Julie K.; Baxi, Sangita; Chen, Christine; Akinniranye, Olamigoke; Hall, Owen; Larkin, Jody; Motala, Aneesa et al. (2021-06-09). Radiation Therapy for Brain Metasases (Report). Agency for Healthcare Research and Quality (AHRQ). doi:10.23970/ahrqepccer242. https://effectivehealthcare.ahrq.gov/products/radiation-therapy-brain-metastases/research. 
  7. ↑ Radiation Therapy for Brain Metasases (Report). Agency for Healthcare Research and Quality (AHRQ). 2021-06-09. doi:10.23970/ahrqepccer242. https://effectivehealthcare.ahrq.gov/products/radiation-therapy-brain-metastases/research. 
  8. ↑ "Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline". Journal of Clinical Oncology 40 (5): 492–516. February 2022. doi:10.1200/JCO.21.02314. PMID 34932393. 



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