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

Turkish Hospital Begins MR-Guided Radiation Therapy With Viewray MRIdian Linac
News | Image Guided Radiation Therapy (IGRT) | September 21, 2018
ViewRay Inc. announced that Acibadem Maslak Hospital in Istanbul, Turkey has begun treating patients with ViewRay's...
Machine Learning IDs Markers to Help Predict Alzheimer's

Neurologists use structural and diffusion magnetic resonance imaging (MRI) to identify changes in brain tissue (both gray and white matter) that are characteristic of Alzheimer's disease and other forms of dementia. The MRI images are analyzed using morphometry and tractography techniques, which detect changes in the shape and dimensions of the brain and in the tissue microstructure, respectively. In this example, the images show the normal brain of an elderly patient. Image courtesy of Jiook Cha.

News | Neuro Imaging | September 20, 2018
New research has shown a combination of two different modes of magnetic resonance imaging (MRI), computer-based...
Amar Kishan, M.D.

Amar Kishan, M.D.

News | Prostate Cancer | September 11, 2018
UCLA researchers have discovered that a combination of high doses of...
Videos | Radiation Therapy | September 07, 2018
A discussion with Ehsan Samei, Ph.D., DABR, FAAPM, FSPIE, director of the Duke University Clinical Imaging Physics Gr
Boston Scientific to Acquire Augmenix Inc.
News | Patient Positioning Radiation Therapy | September 07, 2018
Boston Scientific has entered into a definitive agreement to acquire Augmenix Inc., a privately-held company which has...
PET Imaging Agent Predicts Brain Tau Pathology, Alzheimer's Diagnosis
News | PET Imaging | September 05, 2018
Eli Lilly and Co. and Avid Radiopharmaceuticals Inc. announced a Phase 3 study of positron emission tomography (PET)...
Check-Cap Announces Interim Results of European Study of C-Scan System Version 3
News | Colonoscopy Systems | September 04, 2018
Check-Cap Ltd. announced the interim results for its post-CE approval study of the C-Scan system Version 3, an...
Brain Iron Levels May Predict Multiple Sclerosis Disabilities
News | Neuro Imaging | August 31, 2018
A new, highly accurate magnetic resonance imaging (MRI) technique can monitor iron levels in the brains of multiple...
Study Finds Multiple Sclerosis Drug Slows Brain Shrinkage

An NIH-funded clinical trial suggested that the anti-inflammatory drug ibudilast may slow brain shrinkage caused by progressive MS. Image courtesy of Robert J. Fox, M.D., Cleveland Clinic.

News | Neuro Imaging | August 30, 2018
August 30, 2018 — Results from a clinical...
Non-Canonical Strategy May Improve Cancer Radiotherapy
News | Radiation Therapy | August 29, 2018
August 29, 2018 — Although the success or failure of...