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Either or Both as the Optimal Treatment

Jeffrey Raizer, MD

JAMA. 2006;295:2535-2536.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Brain metastases are the most feared and debilitating complication of systemic cancers. They affect approximately 170 000 patients a year, with the most common primary tumors being lung cancer, breast cancer, and melanoma.¹ The traditional approach for patients with brain metastases has been whole-brain radiation therapy (WBRT), irrespective of lesion number or primary site.

A shift in treatment occurred for patients with a single brain metastasis after 3 randomized trials were completed.^2-4 In these trials patients were randomized to receive WBRT alone or surgical resection of a single brain metastasis followed by WBRT. In studies by Patchell et al² and Noordijk et al,³ resection of a single brain metastasis prior to WBRT led to an increase in median survival of 25 and 17 weeks, respectively. There was also a significant increase in functionality for the surgical group in both studies. A study by Mintz et al⁴ did not . . . [Full Text of this Article]

Author Affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Ill.

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Radiosurgery Plus Whole-Brain Radiation Therapy for Brain Metastases
Roy A. Patchell, William F. Regine, Jay S. Loeffler, Raymond Sawaya, David W. Andrews, and Lawrence S. Chin
JAMA. 2006;296(17):2089-2090.
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Radiosurgery Plus Whole-Brain Radiation Therapy for Brain Metastases—Reply
Hidefumi Aoyama, Hiroki Shirato, Masao Tago, Keiichi Nakagawa, and Gen Kobashi
JAMA. 2006;296(17):2090.
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Radiosurgery Plus Whole-Brain Radiation Therapy for Brain Metastases—Reply
Jeffrey Raizer
JAMA. 2006;296(17):2090-2091.
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Stereotactic Radiosurgery Plus Whole-Brain Radiation Therapy vs Stereotactic Radiosurgery Alone for Treatment of Brain Metastases: A Randomized Controlled Trial
Hidefumi Aoyama, Hiroki Shirato, Masao Tago, Keiichi Nakagawa, Tatsuya Toyoda, Kazuo Hatano, Masahiro Kenjyo, Natsuo Oya, Saeko Hirota, Hiroki Shioura, Etsuo Kunieda, Taisuke Inomata, Kazushige Hayakawa, Norio Katoh, and Gen Kobashi
JAMA. 2006;295(21):2483-2491.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Radiosurgery plus whole-brain radiation therapy for brain metastases.
Patchell et al.
JAMA 2006;296:2089-2090.
FULL TEXT