Is whole-brain radiation still best for brain metastases from small-cell lung cancer?
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IMAGE: Chad Rusthoven, M.D., and University of Colorado Cancer Center colleagues show promise of targeted radiation against brain metastases from small-cell lung cancer. view more 

Credit: University of Colorado Cancer Center

Lung cancer often metastasizes to the brain. Historically, brain metastases have been treated with whole-brain radiation therapy. However, whole-brain radiation is associated with cognitive side-effects and studies of non-small cell lung cancer patients have shown that a more targeted form of radiation, known as stereotactic radiosurgery, can improve cognitive outcomes and is highly effective for treating limited numbers of brain metastases. However, these studies have usually excluded patients with the related but different form of the disease known as small-cell lung cancer and, for patients with this tumor type, whole-brain radiation remains the standard of care for limited and even solitary brain metastases.

A recent study from investigators at the University of Colorado Cancer Center challenges the use of whole-brain radiation for all small-cell lung cancer patients with brain metastases. The study, recently published in the journal Lung Cancer, compared the outcomes of 5,752 small-cell lung cancer patients who received whole-brain radiation therapy (WBRT) with those of 200 patients who received stereotactic radiosurgery (SRS), finding that the median

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