Cancer patients younger than 50 with a limited number of brain metastases have better survival when treated with stereotactic radiosurgery (SRS) that is not combined with whole-brain radiotherapy (WBRT).
That's according to a study presented at the American Society for Radiation Oncology (ASTRO) annual meeting this week in Atlanta.
These younger patients were also found to be at no greater risk of developing new brain metastases, despite omission of WBRT, said researchers from Sunnybrook Health Sciences Centre in Toronto.
The study data came from three randomized clinical trials conducted in North America, Europe, and Asia. Lead author Dr. Arjun Sahgal and colleagues evaluated the results of SRS alone versus WBRT with SRS for patients with one to four brain metastases.
In total, 364 patients from the three trials were evaluated. Of those, 51% were treated with stereotactic radiosurgery alone and 49% with both WBRT and SRS. Nineteen percent were 50 years or younger and 60% had a single brain metastasis.
Sahgal's team found that patients who underwent only SRS had a median survival of 10 months after treatment, compared with 8.2 months for patients who had WBRT in addition to SRS.
The study suggests that WBRT may not be required for all patients with brain metastases, particularly younger patients, and stereotactic radiosurgery alone should be considered as the first-line therapeutic option, the researchers concluded. The findings are significant because other studies have shown that WBRT is detrimental to short-term memory function and that it negatively affects some aspects of patients' quality of life.
