![]() 1 Higher incidences are anticipated due to some patients not screened for BM with brain imaging and the potential for underreporting of BM to population-based registries. 1, 2 In a US population-based study, 2% of patients with cancer, and 12% of those with metastatic disease, presented with BM at initial diagnosis. 1 The incidence of BM depends on cancer type, histology, and stage. The panel for brain malignancies utilized this process to identify areas of controversy that may benefit from future evidence-based guideline development.īrain metastases (BM) are the most common intracranial adult tumor and an increasingly important cause of morbidity and mortality. This methodology, used by the ARS Appropriate Use panels, facilitated the development of consensus guidelines that will be useful to practicing neuro-oncologists, radiation oncologists, neurosurgeons, and medical oncologists. An expert panel voted on treatment options for specific case variants. This systematic review was based upon key questions focusing on neurocognitive outcomes in patients treated with SRS. The impact on neurocognitive function of SRS alone versus WBRT in patients with multiple BM is therefore of particular interest. Single-arm retrospective and prospective data show lesion number to have little or no effect on overall survival among those with ≤10 BM. Emerging data show no detriment in overall survival with the omission of WBRT in patients with 2–4 BM treated with resection or SRS.
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