New brain metastases treatment guidelines released

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The U.S. guidelines for the treatment of brain metastases were released Monday at the 2009 Congress of Neurological Surgeons' (CNS) meeting in New Orleans.

The U.S. guidelines were developed by a 20-member panel headed by Steven Kalkanis, MD, co-director of the Hermelin Brain Tumor Center at Henry Ford Hospital in Detroit. Over the past year, the panel reviewed the literature on brain metastases--which, according to CNS, accounts for nearly 500,000 new cancers every year—and developed a consensus for different treatments.

"In the last 10 years, there has been an explosion of new treatments for brain metastases: surgical resection, stereotactic radiosurgery, whole brain radiation therapy, partial brain radiation, chemotherapy and various combinations of all the above," said Kalkanis. "Because of the growth of these new technologies, there has been wide variation among physicians in how to treat patients. And there hasn't been a central source on which treatment regimens give the best results."

The guidelines include:

  • A range of therapeutic options for treating brain metastases;
  • the existing evidence used to guide decision-making and its limitations;
  • the range of diversity in practice patterns and the various demographic factors that influence clinical decisions; and
  • the impact of expert reviews of published clinical evidence on practice regarding treatment options for brain metastases.

In cases where there was not enough data to suggest a guideline or recommendation for a particular treatment, the report lists all relevant ongoing clinical trials, as well as needed future studies to inform the medical community and to foster support for continuing this important research.

The guidelines will be published in a special issue of the Journal of Neuro-Oncology in December.