Contemporary practice patterns of stereotactic radiosurgery for brain metastasis: A review of published Australian literature

SummaryThere has been a shift in the management of brain metastasis (BM), with increasing use of stereotactic radiosurgery (SRS) and delaying/avoiding whole ‐brain radiotherapy (WBRT), given the concern regarding the long‐term neurocognitive effect and quality of life impact of WBRT. It is, however, unclear as to the contemporary practice pattern and outcomes of SRS in Australia. We conducted a literature search in PubMed and MEDLINE using a series of keywords: ‘stereotactic’, ‘radiosurgery’ and ‘brain metastases’, limiting to Australian studies, which report on clinical outcomes following SRS. Eight studies – one randomized trial and seven retrospective cohort studies – were identified and included in this review. A total of 8 56 patients were included, with the most common primary tumour types being melanoma, lung cancer and breast cancer. Approximately half of the patients had solitary BM, while 7% had 10 or more BM lesions. SRS is not routinely given in combination with WBRT. The 6‐month intracranial control and 1‐ year intracranial control following SRS were reported in the range of 67–87% and 48–82%, respectively, whereas the 1‐year overall survival and 2‐year overall survival were reported in the range of 37–60% and 20–36%, respectively. There are limited data reported on SRS‐related toxicitie s in all included studies. Overall, despite increasing use of SRS for BM, there is a low num...
Source: Journal of Medical Imaging and Radiation Oncology - Category: Radiology Authors: Tags: Radiation Oncology —Review Article Source Type: research

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ConclusionAlthough LM arising from gynecological cancers is considered rare, identification of LM may be important to predict prognosis and develop new therapeutic strategies.
Source: International Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsThere was limited intracranial clinical activity for abemaciclib monotherapy in NSCLC and MEL pts in this study; OIRR and short median PFS suggest that no further studies for abemaciclib monotherapy are warranted in this pt population.Clinical trial identificationNCT02308020.Editorial acknowledgementMedical writing assistance was provided by Kristi Gruver, employee of Eli Lilly and Company.Legal entity responsible for the studyEli Lilly and Company.FundingEli Lilly and Company.DisclosureE. Le Rhun: Advisory / Consultancy, Research grant / Funding (institution), Oscar Lambert Center, Lille, FR: Mundipharma; Resea...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
AbstractBackgroundImmune therapies targeting the programmed cell death receptor (ligand) 1 (PD-1/PD-L1) axis have shown remarkable activity in a variety of solid tumors. While substantial responses were observed in asymptomatic patients with brain metastases (BM), their clinical activity in primary brain tumors remains limited. In a cohort of adult brain tumor patients, we aimed to analyze soluble PD-L1 (sPD-L1) levels in patient plasma as a systemic marker of tumor - immune system interactions.MethodsWe obtained EDTA plasma from 55 glioblastoma, 26 lower-grade (WHO grade II - III) glioma (LGG), 17 meningioma and 43 BM pat...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
FINDINGSCancer that has spread to the central nervous system is notoriously difficult to treat. Now, UCLA researchers have developed a drug delivery system that breaks through the blood-brain barrier in order to reach and treat cancer that has spread to the central nervous system.In research conducted in mice, a single dose of cancer drugs in a nanoscale capsule developed by the scientists eliminated all B-cell lymphoma that had metastasized to the animals ’ central nervous system.BACKGROUNDAbout 15% to 40% of all cancers spread to the nervous system, but there are few treatment options and they only work in a small ...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
F, Kamp MA Abstract 5-ALA fluorescence-guided surgery (FGS) is a major advance in neuro-oncological surgery. So far, Protoporphyrin IX (PpIX)-fluorescence has been observed in about half of cerebral metastases resected with routinely equipped microscopes during 5-ALA FGS. The aim of the present pilot study was to quantify PpIX-induced fluorescence of cerebral metastases with a spectrometer. We hypothesize that non-fluorescing metastases under the operating microscope may have spectrometrically measurable levels of fluorescence. A second aim was to analyze correlations between quantified 5-ALA fluorescence and hist...
Source: Clinical Breast Cancer - Category: Cancer & Oncology Authors: Tags: Clin Exp Metastasis Source Type: research
Of all patients diagnosed with cancer, 8 –10% will develop brain metastases (BM) [1]. This incidence is expected to increase with more effective treatments for the primary tumours, thereby improving survival and thus increasing the time for possible dissemination of tumour to the brain [1,2]. Brain metastases most frequently originate fr om lung cancer, breast cancer and melanoma [1–5], but in up to 14% of patients, the metastases are of unknown origin [3–5].
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
Brain metastases are the most common intracranial tumours and occur in 20-40% of all cancer patients. Lung cancer, breast cancer, and melanoma are the most frequent primary cancer to develop brain metastases. Treatment options include surgical resection, whole brain radiotherapy, stereotactic radiosurgery and systemic treatment such as targeted or immune therapy. Anatomical magnetic resonance imaging (MRI) of the tumour (in particular post-Gadolinium T1-weighted and T2-weighted FLAIR) provide information about lesion morphology and structure, and are routinely used in clinical practice for both detection and treatment resp...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Authors: Niranjan A, Lunsford LD, Ahluwalia MS Abstract The most common primary cancers that metastasize to the brain are lung cancer, breast cancer, and melanoma. The established management approaches for brain metastasis include stereotactic radiosurgery, fractionated radiation therapy, and surgical resection. In the past the role of medical therapies in brain metastases was limited. In the last decade, our understanding of molecular drivers of brain metastases and CNS penetration of drugs across the blood-brain barrier has improved. The molecular targeted tyrosine kinase inhibitors have shown effectiveness in br...
Source: Progress in Neurological Surgery - Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
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Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
FRIDAY, May 3, 2019 -- Elderly patients with lung cancer, breast cancer, or melanoma are at increased risk for brain metastases (BMs) later in life, according to a study published online May 3 in Cancer Epidemiology, Biomarkers&...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
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