Abstract
The role of selected treatments for brain metastases (BM) is well documented; however, the prevalence of these is not. We report on the patterns of care in the management of BM in a large oncology centre. We retrospectively audited 236 cases of newly diagnosed BM from January 2016 to December 2017 by looking at 2years of radiology reports and gathered data on primary site, survival, treatment received, palliative care input and brain metastases-related admissions. Eighty-two per cent of cases were related to lung, breast and melanoma primaries. Half of patients received a form of treatment with the other half receiving best supportive care. Of these, whole-brain radiotherapy (39%) and stereotactic radiosurgery (40%) were the most common treatment modalities. Most common reasons for admissions were headaches, seizures, weakness and confusion. This is the first study in the UK that gives an in-depth overview of the real-world management of brain metastases. We have demonstrated the prevalence of treatment across the spectrum of brain metastases patients. Radiotherapy is the mainstay of treatment in nearly 80% of cases; however, care needs to be taken in ensuring that SRS is offered to those who are suitable.
Highlights
Brain metastases occur in 20-40% of patients with metastatic cancer (Nathoo, Chahlavi, Barnett, & Toms, 2005)
We have demonstrated the prevalence of treatment across the spectrum of brain metastases patients
Radiotherapy is the mainstay of treatment in nearly 80% of cases; care needs to be taken in ensuring that stereotactic radiosurgery (SRS) is offered to those who are suitable
Summary
Brain metastases occur in 20-40% of patients with metastatic cancer (Nathoo, Chahlavi, Barnett, & Toms, 2005). The last decade has seen significant advances in systematic anti-cancer treatment (SACT) and patients are living longer than ever before. Despite these advances, brain metastases represent a unique challenge as many SACTs do not reliably cross the blood-brain barrier. The results of the QUARTZ trial has led to WBRT falling out of favour in the UK for lung cancer patients (Mulvenna et al, 2016) and it’s known neurocognitive toxicity has led to concerted efforts to manage brain metastases differently, either with hippocampal sparing WBRT or with stereotactic radiosurgery (SRS) (Gondi et al, 2014; Pinkham, Sanghera, Wall, Dawson, & Whitfield, 2015). Clinical Commissioning Policy: Stereotactic Radiosurgery/Radiotherapy for Cerebral Metastases. (Reference: NHSCB/D05/P/d NHS Commissioning Board), 2013)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
