Whole brain radiotherapy (WBRT) is a treatment option for patients with
brain metastases. In WBRT, radiation therapy is administered broadly, to the whole brain, over multiple treatments.
Usage
WBRT has been shown to alleviate symptoms, decrease the use of
corticosteroids
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are invol ...
needed to control tumor-associated
edema
Edema (American English), also spelled oedema (British English), and also known as fluid retention, swelling, dropsy and hydropsy, is the build-up of fluid in the body's tissue (biology), tissue. Most commonly, the legs or arms are affected. S ...
, and potentially improve overall survival.
However, WBRT has been reported to increase the risk of
cognitive decline
Cognitive impairment is an inclusive term to describe any characteristic that acts as a barrier to the cognition process or different areas of cognition. Cognition, also known as cognitive function, refers to the mental processes of how a person ...
.
However, single trials suggest that WBRT with memantine or hippocampal sparing may delay cognitive decline, though these methods did not improve survival or quality of life.
WBRT may be administered in combination with
stereotactic radiosurgery
Stereotactic surgery is a minimally invasive form of surgery, surgical intervention that makes use of a three-dimensional coordinates, coordinate system to locate small targets inside the body and to perform on them some action such as ablation, ...
(SRS), surgery, or systemic therapies.
Based on data, WBRT combined with systemic therapies increased the likelihood of vomiting but overall, there were no other major differences regarding adverse events between these two treatment methods.
While these can improve survival for some patients with single brain metastasis, a 2021 systematic review of the literature found inconsistent results for overall survival.
References
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Chemotherapy