Grand Rounds: “Brain Metastases: Finally a Light at the End of this Long Dark Tunnel”

Today Dr. Elizabeth Maher gave a fantastic talk on the current clinical management and her research on brain metastases. She gave a great summary of the current guidelines for the management of brain mets by the The American Society of Radiation Oncology outlined below:

1. Single brain mets, larger than 3-4 cm, amenable to surgery with good prognosis (survival >3 months) –> Surgical reserction and WBRT (level 1 evidence). If smaller than 3-4 cm consider radiosurgery alone or WBRT and radiosurgery. If non resectable single brain met, WBRT can be considered (level 3)

2. Multiple brain mets and good prognosis (survival < 3 months) –> Radiosurgery + WBRT, Radiosurgery alone or WBRT alone can be considered (level 3)

3. Patients with poor prognosis (survival < 3 months) and single or multiple brain mets –> Palliative care +/- WBRT (level 3)

During her talk she also referenced a recent publication by our own Chair of Internal Medicine, Dr. David Johnson. Read his article here:

http://jco.ascopubs.org/content/32/10/973.long