RESEARCH HIGHLIGHTS Nature Reviews Clinical Oncology 11, 242 (2014); published online 25 March 2014; doi:10.1038/nrclinonc.2014.56
SURGERY
Stereotactic radiosurgery—new options for multiple brain metastases? Brain metastases are among the most life-threatening complications of cancer, arising in 20–40% of patients. Whole‑brain radiotherapy (WBRT) is the standard treatment for patients with newly diagnosed brain metastases, regardless of the number of tumours or histology. Yamamoto, Serizawa and colleagues have recently reported that the use of stereotactic radiosurgery alone in patients with 5–10 brain metastases should be considered as an alternative to WBRT. Stereotactic radiosurgery has several advantages, but most importantly the incidence of the deterioration of neurocognitive function is much lower than with WBRT. Currently, the American Society for Radiation Oncology evidencebased guidelines for newly diagnosed brain metastases recommend stereotactic radiosurgery alone for the management of patients with 1–4 cancers. However, the role of this therapeutic approach for patients with ≥5 brain tumours is not clear, which urged Yamamoto and Serizawa
to design the first sufficiently powered prospective observational study to assess such scenario. The investigators enrolled 1,194 patients with 1–10 brain metastases. As expected, stereotactic radiosurgery was highly effective in patients with one tumour. Of note, an identical median overall survival of 10.8 months for patients with 1–4 or 5–10 metastases was reported. These results prove the non-inferiority of stereotactic radiosurgery in these two groups of patients. The role of stereotactic radiosurgery in the management of patients with ≥5 brain metastases will be confirmed in an ongoing randomized trial (NCT01731704) that compares stereotactic radiosurgery versus WBRT for patients with 5–10 brain metastases. Alessia Errico Original article Yamamoto, M. et al. Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol. doi:10.1016/S1470-2045(14)70061-0
NATURE REVIEWS | CLINICAL ONCOLOGY
VOLUME 11 | MAY 2014 © 2014 Macmillan Publishers Limited. All rights reserved
SURGERY
Stereotactic radiosurgery—new options for multiple brain metastases? Brain metastases are among the most life-threatening complications of cancer, arising in 20–40% of patients. Whole‑brain radiotherapy (WBRT) is the standard treatment for patients with newly diagnosed brain metastases, regardless of the number of tumours or histology. Yamamoto, Serizawa and colleagues have recently reported that the use of stereotactic radiosurgery alone in patients with 5–10 brain metastases should be considered as an alternative to WBRT. Stereotactic radiosurgery has several advantages, but most importantly the incidence of the deterioration of neurocognitive function is much lower than with WBRT. Currently, the American Society for Radiation Oncology evidencebased guidelines for newly diagnosed brain metastases recommend stereotactic radiosurgery alone for the management of patients with 1–4 cancers. However, the role of this therapeutic approach for patients with ≥5 brain tumours is not clear, which urged Yamamoto and Serizawa
to design the first sufficiently powered prospective observational study to assess such scenario. The investigators enrolled 1,194 patients with 1–10 brain metastases. As expected, stereotactic radiosurgery was highly effective in patients with one tumour. Of note, an identical median overall survival of 10.8 months for patients with 1–4 or 5–10 metastases was reported. These results prove the non-inferiority of stereotactic radiosurgery in these two groups of patients. The role of stereotactic radiosurgery in the management of patients with ≥5 brain metastases will be confirmed in an ongoing randomized trial (NCT01731704) that compares stereotactic radiosurgery versus WBRT for patients with 5–10 brain metastases. Alessia Errico Original article Yamamoto, M. et al. Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol. doi:10.1016/S1470-2045(14)70061-0
NATURE REVIEWS | CLINICAL ONCOLOGY
VOLUME 11 | MAY 2014 © 2014 Macmillan Publishers Limited. All rights reserved
