Treatment of brain metastases in small cell lung cancer: Decision-making amongst a multidisciplinary panel of European experts.

Putora, Paul Martin; Fischer, G F; Früh, Martin; Califano, R; Faivre-Finn, C; Van Houtte, P; McDonald, F; Nestle, U; Dziadziuszko, R; Le Pechoux, C; Ramella, S; Belderbos, J; Slotman, B J; Troost, E G C; Peeters, S; Widder, J; Pöttgen, C; Reck, M; Blackhall, F; Cappuzzo, F; ... (2020). Treatment of brain metastases in small cell lung cancer: Decision-making amongst a multidisciplinary panel of European experts. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 149, pp. 84-88. Elsevier Scientific Publ. Ireland 10.1016/j.radonc.2020.04.015

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BACKGROUND

Brain metastases (BM) are common in patients with small cell lung cancer (SCLC). In recent years, the role of whole brain radiotherapy (WBRT) for brain metastases in lung cancer is being reevaluated, especially in the context of new systemic treatments available for SCLC. With this analysis, we investigate decision-making in SCLC patients with BM among European experts in medical oncology and radiation oncology.

METHODS

We analyzed decision-making from 13 medical oncologists (selected by IASLC) and 13 radiation oncologists (selected by ESTRO) specialized in SCLC. Management strategies of individual experts were converted into decision trees and analyzed for consensus.

RESULTS AND CONCLUSION

In asymptomatic patients, chemotherapy alone is the most commonly recommended first line treatment. In asymptomatic patients with limited volume of brain metastases, a higher preference for chemotherapy without WBRT among medical oncologists compared to radiation oncologists was observed. For symptomatic patients, WBRT followed by chemotherapy was recommended most commonly. For limited extent of BM in symptomatic patients, some experts chose stereotactic radiotherapy as an alternative to WBRT. Significant variation in clinical decision-making was observed among European SCLC experts for the first line treatment of patients with SCLC and BM.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Putora, Paul Martin and Früh, Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1879-0887

Publisher:

Elsevier Scientific Publ. Ireland

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

24 Jun 2020 16:44

Last Modified:

22 Aug 2020 01:32

Publisher DOI:

10.1016/j.radonc.2020.04.015

PubMed ID:

32445987

Uncontrolled Keywords:

Brain metastases Chemotherapy Decision-making Small cell lung cancer Stereotactic radiotherapy Whole brain radiotherapy

BORIS DOI:

10.7892/boris.144505

URI:

https://boris.unibe.ch/id/eprint/144505

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