The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.
Treatment of single brain metastasis: Radiotherapy alone or combined with neurosurgery
Abstract
Most patients treated for single or multiple brain metastases die from progression of extracranial tumor activity. This makes it uncertain whether the combination of neurosurgery and radiontherapy for treatment of single brain metastasis will lead to better results than less invasive treatment with radiotherapy alone. The effect of neurosurgical excision plus radiotherapy was compared with radiotherapy alone in a prospectively randomized trial with 63 evaluable patients with systemic cancer and a radiological diagnosis of single brain metastasis. Radiotherapy was given to the whole brain by a novel scheme of 2 faractions per day of each 2 Gy for a total of 40 Gy. Before randomization, patients were stratified by site (lung cancer vs nonlung cancer) and status of extracranial disease (progressive vs. stable). Survival as such and functionally independent survival (FIS; defined as world Health Organization performance status ≤ 1 and neurological funcition ≤ 1) were compared between both treatment arms. The combined treatment compared with radiotherapy alone led to a longer survival ( p =0.04) and a longer FIS ( p =0.06). This was most pronounced in patients with stable extracranial disease (median survival, 12vs 7 mo; median FIS 9 vs 4 Mo). Patients with progressive extracranial cancer had a median overall survival of 5 months and a FIS of 2.5 months irrespective of given treatment. Improvement in functional status occurred more rapidly and for longer periods of time after neurosurgial excision and radiotherapy than after radiotherpy alone. Patients older than 60 years had a hazard ratio of dying of 2.74( p =0.001) compared with younger patients, but in both age groups the combined treatment did better then radiotherapy alone. We coclude that patients with single brain metastasis and stable extracranial tumor activity should be treated with surgical excision and radiotherapy. For patients with progressive extracranial disease during the previous 3 months, radiotherapy alone appears to be sufficient. After treatment of single brain metastasis, parients remain functionally independent until a few months before death.
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Cites
A Randomized Trial of Surgery in the Treatment of Single Metastases to the Brain
Patchell, R. A., Tibbs, P. A., Walsh, J. W., Dempsey, R. J., Maruyama, Y., Kryscio, R. J., Markesbery, W. R., Macdonald, J. S., & Young, B. (1990) · New England Journal of Medicine · doi:10.1056/nejm199002223220802 · Cited by 3,135
Radiation‐induced dementia in patients cured of brain metastases
DeAngelis, L. M., Delattre, J.-Y., & Posner, J. B. (1989) · Neurology · doi:10.1212/wnl.39.6.789 · Cited by 941
Intracerebral metastases in solid-tumor patients: Natural history and results of treatment
Zimm, S., Wampler, G. L., Stablein, D., Hazra, T., & Young, H. F. (1981) · Cancer · doi:10.1002/1097-0142(19810715)48:2<384::aid-cncr2820480227>3.0.co;2-8 · Cited by 601
Kurtz, J. M., Gelber, R., Brady, L. W., Carella, R. J., & Cooper, J. S. (1981) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/0360-3016(81)90005-5 · Cited by 331
The Role of Postoperative Radiotherapy after Resection of Single Brain Metastases
DeAngelis, L. M., Mandell, L. R., Thaler, H. T., Kimmel, D. W., Galicich, J. H., FUKS, Z. Y., & Posner, J. B. (1989) · Neurosurgery · doi:10.1227/00006123-198906000-00002 · Cited by 282
Smalley, S. R., Schray, M. F., Laws, E. R., & O'Fallon, J. R. (1987) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/0360-3016(87)90154-4 · Cited by 225
The role of postoperative radiotherapy after resection of single brain metastases
DeAngelis, L. M., Mandell, L. R., Thaler, H. T., Kimmel, D. W., Galicich, J. H., Fuks, Z., & Posner, J. B. (1989) · Neurosurgery · doi:10.1097/00006123-198906000-00002 · Cited by 217
Diener-West, M., Dobbins, T. W., Phillips, T. L., & Nelson, D. F. (1989) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/0360-3016(89)90483-5 · Cited by 204
Vecht, C. J., Avezaat, C. J., van Putten, W. L., Eijkenboom, W. M., & Stefanko, S. Z. (1990) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.53.6.466 · Cited by 185
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Novello, S., Barlesi, F., Califano, R., Cufer, T., Ekman, S., Levra, M. G., Kerr, K., Popat, S., Reck, M., Senan, S., et al. (2016) · Annals of Oncology · doi:10.1093/annonc/mdw326 · Cited by 2,631
Planchard, D., Popat, S., Kerr, K., Novello, S., Smit, E. F., Faivre-Finn, C., Mok, T. S., Reck, M., Van Schil, P. E., Hellmann, M. D., et al. (2018) · Annals of Oncology · doi:10.1093/annonc/mdy275 · Cited by 2,274
Le Rhun, E., Weller, M., Brandsma, D., Van den Bent, M., de Azambuja, E., Henriksson, R., Boulanger, T., Peters, S., Watts, C., Wick, W., et al. (2017) · Annals of Oncology · doi:10.1093/annonc/mdx221 · Cited by 637
The biology of brain metastases—translation to new therapies
Eichler, A. F., Chung, E., Kodack, D. P., Loeffler, J. S., Fukumura, D., & Jain, R. K. (2011) · Nature Reviews Clinical Oncology · doi:10.1038/nrclinonc.2011.58 · Cited by 567
Tsao, M. N., Rades, D., Wirth, A., Lo, S. S., Danielson, B. L., Gaspar, L. E., Sperduto, P. W., Vogelbaum, M. A., Radawski, J. D., Wang, J. Z., et al. (2012) · Practical Radiation Oncology · doi:10.1016/j.prro.2011.12.004 · Cited by 587
Metadata
- Authors
- Vecht, C. J., Haaxma‐Reiche, H., Noordijk, E. M., Padberg, G. W., Voormolen, J. H. C., Hoekstra, F. H., Tans, J. T. J., Lambooij, N., Metsaars, J. A. L., Wattendorff, A. R., Brand, R., & Hermans, J.
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 1993-06
- Volume
- 33
- Issue
- 6
- Pages
- 583-590
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- OpenAlex
- W2004852620
- Cited by
- 1,049
- References
- 9
- FWCI
- 10.38
- Type
- journal article
- Language
- en
- Open access
- closed
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- Vecht, C. J., Haaxma‐Reiche, H., Noordijk, E. M., Padberg, G. W., Voormolen, J. H. C., Hoekstra, F. H., Tans, J. T. J., Lambooij, N., Metsaars, J. A. L., Wattendorff, A. R., Brand, R., & Hermans, J. (1993). Treatment of single brain metastasis: Radiotherapy alone or combined with neurosurgery. Annals of Neurology. https://doi.org/10.1002/ana.410330605
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