Questions discussed in this category
Do you increase the dosage of the TKI or switch to a different generation TKI? How does your answer differ for EGFR vs. ALK, and for discrete brain me...
Controlled extracranial disease on trastuzumab+pertuzumab for 2 years. Treatment options include Enhertu or WBRT. Not a candidate for SRS or neurosurg...
Would you offer consolidative brain SRS, SRS + consolidative RT to the primary (e.g. lung), consolidative RT to the primary alone?
This has become standard practice at our institution for patients with a good performance status, with whole brain radiotherapy given after the comple...
How often are you scanning the brain and what is your trigger to treat?
CNS recurrence occurred within two years of prior neoadjuvant therapy
The patient is treatment naïve and asymptomatic. She also has disease in the body (bone and liver metastases).
Patient completed neoadjuvant therapy with TCH 2 years prior, and has no evidence of disease outside the CNS on PET/CT.
Would this be any different for whole brain radiotherapy?
Can SRS or whole brain radiotherapy be reserved for progression in these young, healthy patients?
Some medical oncologists tend to hold anticoagulation in patients who develop brain metastases for fear of causing intracranial hemorrhage. Is t...
Does the extent/duration of systemic disease control (complete response vs. stable disease, for example) influence your decision? What about whe...
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Papers discussed in this category
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Lancet, 2015 Jan 3
International journal of radiation oncology, biology, physics, 2011-11-01
Int. J. Radiat. Oncol. Biol. Phys., 2006-09-01
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Lancet Oncol., 2017-05-01
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Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2007-04-01
J Clin Oncol, 2011 Jan 10
JAMA, 2016-07-26
Radiation oncology (London, England), 2014-09-30
Cancer, 2016-06-15
J. Clin. Oncol., 2018 May 22
Lung cancer (Amsterdam, Netherlands), 2018-06
The New England journal of medicine, 2018-08-23
The New England journal of medicine, 2018-12-06
International journal of radiation oncology, biology, physics, 2019-04-01
Lancet, 2019 Oct 04
JAMA oncology, 2019-06-01
International journal of radiation oncology, biology, physics, 2019-04-01
International journal of radiation oncology, biology, physics, 2019-04-01
Neurosurgery, 2019 Oct 10
JAMA Oncol, 2020 Jun 4
J Clin Oncol, 2020 Aug 10
Lung Cancer, 2014 Aug 02
N Engl J Med,
Lancet Oncol, 2020 Apr 03
Int J Radiat Oncol Biol Phys,
JAMA,
J Neurosurg,
Cancer,
International journal of radiation oncology, biology, physics, 2018-03-15
International journal of radiation oncology, biology, physics, 2016-06-01
Int. J. Radiat. Oncol. Biol. Phys.,
Radiat Oncol, 2015 May 27
International journal of radiation oncology, biology, physics, 2016-06-01
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-04-01
The New England journal of medicine, 2016-11-10
The New England journal of medicine, 2018-01-11
N. Engl. J. Med.,
Blood, 2015-07-23
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024 Jun 03
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2021 May 11
J Thorac Oncol, 2016 Oct 07
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-04-01
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Pract Radiat Oncol, 2020 May - Jun
J Clin Oncol, 2021 Jan 27
Cancer, 2010 Aug 27
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-07-20
N Engl J Med, 2021 Apr 22
Nat Med, 2022 Aug 08
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023 Aug 21