Radiosurgery Improves Clinical Outcomes in Brain Metastasis Treatment

Joshua Palmer, MD, radiation oncologist, The James Cancer Hospital and Research Institute, Wexner Medical Center at The Ohio State University, discusses a pooled analysis of 2 randomized clinical trials that compared how clinical outcomes and quality of life were impacted with stereotactic radiosurgery versus whole-brain radiation therapy (WBRT) in patients with brain metastases.

Palmer presented the results from the pooled analysis in a presentation during the 2020Society for Neuro-Oncology (SNO) Virtual Conference on Brain Metastases, held on August 14, 2020.

Due to the aggressive of radiation treatments, radiation oncologists have not been able to improve survival in patients being treated for brain metastases. Instead, the clinical outcomes typically impacted by radiation is tumor control, cognition, and quality of life in patients. Since overall survival is improved upon with the use of systemic therapies, such as targeted therapies, in order for radiation to sustain its role in treatment, radiation oncologists must focus on how they impact patients’ quality of life, Palmer stated. This was the goal of the pooled analysis.

The results showed that in patients who received WBRT there was a 2-year trend toward increased cognitive decline in 5 out of 6 cognitive measures, whereas patients who underwent stereotactic radiosurgery only had a decline in 2 out of the 6 cognitive measures. Both arms demonstrated a decline in delayed recall and delayed recognition. On the other hand, processing speed, executive function, and word association improved in the stereotactic radiosurgery arm versus the WBRT arm.