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Brain metastases guidelines

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https://www.readbyqxmd.com/read/29750751/the-impact-of-patient-characteristics-and-disease-specific-factors-on-first-line-treatment-decisions-for-braf-mutated-melanoma-results-from-a-european-expert-panel-study
#1
Paolo A Ascierto, Lars Bastholt, Pier F Ferrucci, Johan Hansson, Iván Márquez Rodas, Miranda Payne, Caroline Robert, Luc Thomas, Jochen S Utikal, Pascal Wolter, Amber Kudlac, Harriet Tuson, Jan McKendrick
Treatment decisions for advanced melanoma are increasingly complex and guidelines provide limited advice on how to choose between immunotherapy and targeted therapy for first-line treatment. A Delphi study was carried out to understand which patient characteristics and disease-related factors inform clinicians' choices of first-line treatment for BRAF-mutated melanoma. Twelve European melanoma specialists experienced in using immunotherapies and targeted agents participated in a double-blind two-phase Delphi study...
May 10, 2018: Melanoma Research
https://www.readbyqxmd.com/read/29745036/non-small-cell-lung-cancer-brain-metastasis-screening-in-the-era-of-positron-emission-tomography-ct-staging-current-practice-and-outcomes
#2
Mauricio E Diaz, Maciej Debowski, Craig Hukins, David Fielding, Kwun M Fong, Catherine S Bettington
INTRODUCTION: Several clinical guidelines indicate that brain metastasis screening (BMS) should be guided by disease stage in non-small cell lung cancer (NSCLC). We estimate that screening is performed more broadly in practice, and patients undergo brain imaging at considerable cost with questionable benefit. Our aim was to quantify the use and detection rate of BMS in a contemporary cohort staged with 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). METHODS: We conducted a retrospective review of prospectively collected data from three major lung cancer referral centres in Brisbane between January 2011 and December 2015...
May 10, 2018: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/29559208/prophylactic-cranial-irradiation-for-limited-stage-small-cell-lung-cancer-survey-of-us-radiation-oncologists-on-current-practice-patterns
#3
Matthew J Farrell, Jehan B Yahya, Catherine Degnin, Yiyi Chen, John M Holland, Mark A Henderson, Jerry J Jaboin, Matthew M Harkenrider, Charles R Thomas, Timur Mitin
PURPOSE: Prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer (LS-SCLC) is considered the standard of care. Meta-analysis of 7 clinical trials indicates a survival benefit to PCI, but all of these trials were conducted in the pre-magnetic resonance imaging (MRI) era. Therefore, routine brain imaging with MRI before PCI-as recommended by National Comprehensive Cancer Network guidelines-is not directly supported by the evidence. Current US practice patterns for patients with LS-SCLC are unknown...
February 23, 2018: Clinical Lung Cancer
https://www.readbyqxmd.com/read/29503779/fractionated-radiosurgery-alone-for-thirty-seven-brain-metastases-not-everything-that-can-be-counted-counts
#4
Christian Hyde, Shannon Kinser, Christopher Croft, Patricia Schantz, Kayla Brown, Rajendra Vazirani, Jikun Wei, Ioana Bonta
There is an ongoing debate as to the maximum number of brain metastases that can safely and practically be treated with a single course of radiosurgery. Despite evidence of durable local control and favorable overall survival when treating 10 or more brain metastases with radiosurgery alone, some institutions and guidelines still limit radiosurgery to an arbitrary number of metastases. As demonstrated by this case report, the number of lesions is not so important when the patient's life expectancy is otherwise good and body tumors are controllable...
December 25, 2017: Curēus
https://www.readbyqxmd.com/read/29495089/systematic-review-and-narrative-summary-treatments-for-and-risk-factors-associated-with-respiratory-tract-secretions-death-rattle-in-the-dying-adult
#5
REVIEW
Hildegard Kolb, Austyn Snowden, Elaine Stevens
AIM: To identify effective treatments and risk factors associated with death rattle in adults at the end of life. BACKGROUND: The presence of noisy, pooled respiratory tract secretions is among the most common symptoms in dying patients around the world. It is unknown if "death rattle" distresses patients, but it can distress relatives and clinicians. Treatments appear unsatisfactory, so prophylaxis would be ideal if possible. DESIGN: Quantitative systematic review and narrative summary following Cochrane Collaboration guidelines...
March 1, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29484515/early-stage-non-small-cell-lung-cancer-patients-need-brain-imaging-regardless-of-symptoms
#6
Takahiro Ando, Hidenori Kage, Minako Saito, Yosuke Amano, Yasushi Goto, Jun Nakajima, Takahide Nagase
BACKGROUND: Japanese Lung Cancer Society and ESMO guideline recommends screening for brain metastasis in all patients with non-small cell lung cancer (NSCLC), while NCCN/ACCP guidelines do not recommend screening patients who are asymptomatic and with clinical stage I NSCLC. However, brain metastasis sometimes occurs in early stage NSCLC patients without any neurological symptoms. METHODS: We retrospectively reviewed medical records of 124 patients admitted to the University of Tokyo Hospital with stage IV NSCLC from January 2012 to April 2016...
February 26, 2018: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29348161/cns-metastases-needn-t-rule-out-trial-inclusion
#7
(no author information available yet)
New guidelines from an expert working group describe when to include or exclude patients with brain metastases from clinical trials. In the past, these patients have often been inappropriately excluded from trials, resulting in a dearth of information on the efficacy of cancer drugs in the central nervous system.
March 2018: Cancer Discovery
https://www.readbyqxmd.com/read/29329006/ongoing-unmet-needs-in-treating-estrogen-receptor-positive-her2-negative-metastatic-breast-cancer
#8
REVIEW
Gül A Başaran, Chris Twelves, Véronique Diéras, Javier Cortés, Ahmad Awada
Estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2 negative (HER2-) advanced or metastatic breast cancer (MBC) is the most common MBC subtype and currently remains incurable, with a median overall survival of 24.8 months (95% confidence interval, 21.3-30.3). Common sites of metastases are bone, viscera, and brain, causing significant symptoms that negatively affect patient functioning, quality of life (QoL), and work productivity. Guidelines state that endocrine therapy (ET) is preferable to chemotherapy as first-line treatment for patients with ER+ MBC, regardless of limited visceral metastases, unless rapid tumor response is required or ET resistance is suspected...
February 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29304360/clinical-trial-design-for-local-therapies-for-brain-metastases-a-guideline-by-the-response-assessment-in-neuro-oncology-brain-metastases-working-group
#9
REVIEW
Brian M Alexander, Paul D Brown, Manmeet S Ahluwalia, Hidefumi Aoyama, Brigitta G Baumert, Susan M Chang, Laurie E Gaspar, Steven N Kalkanis, David R Macdonald, Minesh P Mehta, Riccardo Soffietti, John H Suh, Martin J van den Bent, Michael A Vogelbaum, Jeffrey S Wefel, Eudocia Q Lee, Patrick Y Wen
The goals of therapeutic and biomarker development form the foundation of clinical trial design, and change considerably from early-phase to late-phase trials. From these goals, decisions on specific clinical trial design elements, such as endpoint selection and statistical approaches, are formed. Whereas early-phase trials might focus on finding a therapeutic signal to make decisions on further development, late-phase trials focus on the confirmation of therapeutic impact by considering clinically meaningful endpoints...
January 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29304358/clinical-trial-design-for-systemic-agents-in-patients-with-brain-metastases-from-solid-tumours-a-guideline-by-the-response-assessment-in-neuro-oncology-brain-metastases-working-group
#10
REVIEW
D Ross Camidge, Eudocia Q Lee, Nancy U Lin, Kim Margolin, Manmeet S Ahluwalia, Martin Bendszus, Susan M Chang, Janet Dancey, Elisabeth G E de Vries, Gordon J Harris, F Stephen Hodi, Andrew B Lassman, David R Macdonald, David M Peereboom, David Schiff, Ricardo Soffietti, Martin J van den Bent, Jeffrey S Wefel, Patrick Y Wen
Patients with active CNS disease are often excluded from clinical trials, and data regarding the CNS efficacy of systemic agents are usually obtained late in the drug development process or not at all. In this guideline from the Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) working group, we provide detailed recommendations on when patients with brain metastases from solid tumours should be included or excluded in clinical trials of systemic agents. We also discuss the limitations of retrospective studies in determining the CNS efficacy of systemic drugs...
January 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29208355/usage-of-prophylactic-cranial-irradiation-in-elderly-patients-with-small-cell-lung-cancer
#11
Ronald A M Damhuis, Suresh Senan, Jose S Belderbos
BACKGROUND: Prophylactic cranial irradiation (PCI) reduces the risk of overt brain metastases in patients with small-cell lung cancer (SCLC) and is currently recommended in guidelines for both limited and extensive disease. Given the concerns about the greater frequency of neurologic side effects in elderly patients, we studied the association among age, PCI usage, and survival for SCLC patients in the Netherlands. PATIENTS AND METHODS: Data from the Netherlands Cancer Registry for patients diagnosed with SCLC from 2009 to 2013 were queried...
March 2018: Clinical Lung Cancer
https://www.readbyqxmd.com/read/29204521/factors-influencing-the-utilization-of-prophylactic-cranial-irradiation-in-patients-with-limited-stage-small-cell-lung-cancer
#12
Benjamin H Lok, Jennifer Ma, Amanda Foster, Carmen A Perez, Weiji Shi, Zhigang Zhang, Bob T Li, Charles M Rudin, Andreas Rimner, Abraham J Wu
Purpose: Brain metastases are common in patients with limited-stage small cell lung cancer (LS-SCLC) due to the inability of most chemotherapeutics to penetrate the blood-brain barrier. Prophylactic cranial irradiation (PCI) is therefore recommended for use in patients with a good response to concurrent chemoradiotherapy. However, PCI is not always delivered; therefore, we investigated the reasons for PCI omission in patients who underwent therapy with curative intent. Methods and materials: We retrospectively reviewed all patients with LS-SCLC who were treated with curative intent at our institution...
October 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29170039/-delineation-of-the-surgical-bed-of-operated-brain-metastases-treated-with-adjuvant-stereotactic-irradiation-a-review
#13
REVIEW
A Keller, G Noël, D Antoni
Stereotactic radiotherapy of the surgical bed of brain metastases is a technique that comes supplant indications of adjuvant whole brain radiotherapy after surgery. After a growing number of retrospective studies, a phase III trial has been presented and validated this indication. However, several criteria such as the dose, the fractionation, the use of a margin and definition of volumes remain to be defined. Our study consisted in making a literature review in order to provide a guideline of delineation of surgical beds of brain metastases, as well as the different modalities of their implementation process...
December 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/29157748/consensus-contouring-guidelines-for-postoperative-completely-resected-cavity-stereotactic-radiosurgery-for-brain-metastases
#14
Hany Soliman, Mark Ruschin, Lilyana Angelov, Paul D Brown, Veronica L S Chiang, John P Kirkpatrick, Simon S Lo, Anita Mahajan, Kevin S Oh, Jason P Sheehan, Scott G Soltys, Arjun Sahgal
PURPOSE: To propose contouring guidelines based on consensus contours generated by 10 international experts for cavity stereotactic radiosurgery (SRS), an emerging treatment option after surgical resection of brain metastases. No guidelines for contouring the surgical cavity volume have been previously reported. METHODS AND MATERIALS: Ten postoperative completely resected cases with varying clinical scenarios and locations within the brain were selected. For each case, 10 experts independently contoured the surgical cavity clinical target volume (CTV)...
February 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29126142/stereotactic-radiosurgery-in-the-management-of-limited-1-4-brain-metasteses-systematic-review-and-international-stereotactic-radiosurgery-society-practice-guideline
#15
Samuel T Chao, Antonio De Salles, Motohiro Hayashi, Marc Levivier, Lijun Ma, Roberto Martinez, Ian Paddick, Jean Régis, Samuel Ryu, Ben J Slotman, Arjun Sahgal
BACKGROUND: Guidelines regarding stereotactic radiosurgery (SRS) for brain metastases are missing recently published evidence. OBJECTIVE: To conduct a systematic review and provide an objective summary of publications regarding SRS in managing patients with 1 to 4 brain metastases. METHODS: Using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted using PubMed and Medline up to November 2016...
November 3, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28975433/discrepancies-between-biomarkers-of-primary-breast-cancer-and-subsequent-brain-metastases-an-international-multicenter-study
#16
O Kaidar-Person, I Meattini, P Jain, P Bult, N Simone, I Kindts, R Steffens, C Weltens, P Navarria, Y Belkacemi, J Lopez-Guerra, L Livi, B G Baumert, B Vieites, D Limon, N Kurman, K Ko, J B Yu, V Chiang, P Poortmans, T Zagar
PURPOSE: Discordances between the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), expression between primary breast tumors and their subsequent brain metastases (BM) were investigated in breast cancer patients. METHODS: We collected retrospective data from 11 institutions in 8 countries in a predefined-standardized format. Receptor status (positive or negative) was determined according to institutional guidelines (immunohistochemically and/or fluorescence in situ hybridization)...
January 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28968165/modernizing-clinical-trial-eligibility-criteria-recommendations-of-the-american-society-of-clinical-oncology-friends-of-cancer-research-brain-metastases-working-group
#17
Nancy U Lin, Tatiana Prowell, Antoinette R Tan, Marina Kozak, Oliver Rosen, Laleh Amiri-Kordestani, Julia White, Joohee Sul, Louise Perkins, Katherine Beal, Richard Gaynor, Edward S Kim
Purpose Broadening trial eligibility to improve accrual and access and to better reflect intended-to-treat populations has been recognized as a priority. Historically, patients with brain metastases have been understudied, because of restrictive eligibility across all phases of clinical trials. Methods In 2016, after a literature search and series of teleconferences, a multistakeholder workshop was convened. Our working group focused on developing consensus recommendations regarding the inclusion of patients with brain metastases in clinical trials, as part of a broader effort that encompassed minimum age, HIV status, and organ dysfunction...
November 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28839327/role-of-surgery-in-brain-metastases
#18
Altaf Ali Laghari, Syed Ijlal Ahmed, Muhammad Shahzad Shamim
Brain metastases remain the commonest type of brain tumour, being four times more common than primary brain tumours. Although surgical intervention may be recommended for one of various reasons in the management of these tumours, including but not limited to conformation of diagnosis, relief of mass effect, improvement of neurological status and prolongation of survival, the guidelines for management of brain metastases remain largely subjective and therefore controversial. Herein the authors have attempted to review some of the existing evidence on role of surgery in the management of brain metastases and have presented their selected guidelines for the readers...
August 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28836150/anticoagulation-for-the-treatment-of-venous-thromboembolism-in-patients-with-brain-metastases-a-meta-analysis-and-systematic-review
#19
Bradley D Hunter, Tracy Minichiello, Stephen Bent
The risk benefit decision in providing anticoagulation for patients with brain metastases is amongst the most difficult decisions faced by clinicians. The purpose of our study was to evaluate both the risk of intracerebral hemorrhage (ICH) associated with anticoagulation therapy and the effect of anticoagulation on survival in patients with brain metastases and venous thromboembolism (VTE). A systematic review of the literature was performed via the PubMed, EMBASE, and the Cochrane databases. Our initial search resulted in 1304 unique citations, and 5 studies satisfied all eligibility criteria and were included for analysis...
October 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28835132/two-year-experience-of-multi-disciplinary-team-mdt-outcomes-for-brain-metastases-in-a-tertiary-neuro-oncology-centre
#20
Daniel Loh, Florence Hogg, Penelope Edwards, Jillian MacColl, Christian Brogna, Ranjeev Bhangoo, Keyoumars Ashkan, Francesco Vergani
Brain metastases (BMs) are the most common intracranial tumour in adults and form a significant proportion of the neuro-oncology workload. Their management has progressed significantly in the last few decades but a gold-standard evidence-based management strategy has not been defined to date and several guidelines based on available evidence exist to support clinical decision-making. This paper evaluates the decision-making process of the neuro-oncology multi-disciplinary team (MDT) in a tertiary neuro-oncology centre over a two-year period...
August 24, 2017: British Journal of Neurosurgery
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