News | Radiation Therapy | March 03, 2017

UCLA Study Finds Guidelines for Treating Brain Metastases Should Be Overhauled

Survey results indicate split between stereotactic radiosurgery and whole brain radiotherapy depending on location where patients were treated

brain metastases, cancer, survey, UCLA, Dr. Percy Lee, whole brain radiotherapy, stereotactic radiosurgery

Image of a human brain with seven metastases, depicted here as the small colored spheres inside rectangles. Image courtesy of UCLA Jonsson Comprehensive Cancer Center.

March 3, 2017 — An extensive study by University of California Los Angeles (UCLA) researchers found significant variation in treatment strategies for people with three or more brain metastases. The study is bringing light to the need for further research to guide physicians’ decision making.

The researchers also found that there is not enough data to determine which of the two main approaches for treating people that have between three and 10 metastases — stereotactic radiosurgery and whole brain radiotherapy — is most appropriate, although more doctors in an international survey said that stereotactic radiosurgery is their preferred treatment method.

Every year up to 170,000 people in the United States are diagnosed with brain metastases. The risk for metastatic brain tumors depends on the type of cancer people have and how advanced their cancer is when it is first diagnosed. Brain metastases are becoming a more common problem, because people with cancer are living longer thanks to improved treatments for cancer. As a result, their cancer has more time to spread to other parts of their body.

Stereotactic radiosurgery is radiation therapy that precisely targets small brain tumors without damaging healthy tissue. Whole brain radiotherapy involves radiating the entire brain but can cause serious side effects such as decreased cognitive function.

The researchers sent an email survey with questions about patient scenarios and treatment options to more than 5,000 radiation oncologists around the world, and 711 responded.

The study determined that whether people received stereotactic radiosurgery or whole brain radiotherapy depended largely upon the institution where they were treated. The authors also determined that further research is needed to determine which treatment method is most beneficial for patients. Once that is determined, new guidelines should be drafted and more visible outreach efforts are needed to inform oncologists about the updated recommendations.

The study was led by Percy Lee, M.D., associate professor and vice chair of education in the department of radiation oncology at the David Geffen School of Medicine at UCLA. Co-author Michael Steinberg, M.D., is a UCLA professor and chair of the radiation oncology department. Kiri Sandler, M.D., and Narek Shaverdian, M.D., co-first authors, are residents in radiation oncology at UCLA. Other co-authors are Isaac Yang, M.D., assistant professor of neurosurgery, Christopher King, M.D., Ph.D., professor of radiation oncology, and Amar Kishan, M.D., chief resident in radiation oncology. Lee, Steinberg, Yang and King are also members of UCLA's Jonsson Comprehensive Cancer Center.

The study was published online by the journal Cancer.

For more information:


Sandler, K.A., Shaverdian, N., Cook, R.R., Kishan, A.U., et al. "Treatment trends for patients with brain metastases: Does practice reflect the data?" Cancer. Published online Feb. 8, 2017. DOI: 10.1002/cncr.30607

Related Content

Sponsored Content | Videos | Radiation Therapy | January 18, 2019
Join Chris Toth, president of Varian’s Oncology Systems business, for a look at product introductions for 2018 plus
Novel Technique May Significantly Reduce Breast Biopsies
News | Breast Biopsy Systems | January 17, 2019
A novel technique that uses mammography to determine the biological tissue composition of a tumor could help reduce...
Digital Mammography Increases Breast Cancer Detection
News | Mammography | January 16, 2019
The shift from film to digital mammography increased the detection of breast cancer by 14 percent overall in the United...
MIM Software Inc. Receives FDA 510(k) Clearance for Molecular Radiotherapy Dosimetry
Technology | Nuclear Imaging | January 16, 2019
MIM Software Inc. received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for molecular radiotherapy...
Artificial Intelligence Used in Clinical Practice to Measure Breast Density
News | Artificial Intelligence | January 15, 2019
An artificial intelligence (AI) algorithm measures breast density at the level of an experienced mammographer,...
Machine Learning Uncovers New Insights Into Human Brain Through fMRI
News | Neuro Imaging | January 11, 2019
An interdisciplinary research team led by scientists from the National University of Singapore (NUS) has successfully...
Mobile App Data Collection Shows Promise for Population Health Surveys
News | Population Health | January 10, 2019
Mobile app data collection can bring access to more potential clinical study participants, reduce clinical study...
Hypertension With Progressive Cerebral Small Vessel Disease Increases Cognitive Impairment Risk
News | Magnetic Resonance Imaging (MRI) | January 08, 2019
Patients with high blood pressure and progression of periventricular white matter hyperintensities showed signs of...
Artificial Intelligence Pinpoints Nine Different Abnormalities in Head Scans

A brain scan (left) showing an intraparenchymal hemorrhage in left frontal region and a scan (right) of a subarachnoid hemorrhage in the left parietal region. Both conditions were accurately detected by the tool. Image courtesy of Nature Medicine.

News | Artificial Intelligence | January 07, 2019
The rise in the use of computed tomography (CT) scans in U.S. emergency rooms has been a well-documented trend1 in...
Electronic Brachytherapy Effective in Long-Term Study of 1,000 Early-Stage Breast Cancers
News | Brachytherapy Systems, Women's Healthcare | January 07, 2019
Breast cancer recurrence rates of patients treated with intraoperative radiation therapy (IORT) using the Xoft Axxent...