Indications for Radiation Therapy in the Metastatic Setting

  • Painful bone metastasis:
    • Is a well-recognized indication for palliative irradiation
  • Whole-brain irradiation:
    • May also be offered as the primary treatment modality for brain metastases or in combination with surgical resection or stereotactic radio-surgery
  • Studies have demonstrated an improvement in intracranial control:
    • With the addition of radiation following surgery
  • For patients with choroidal involvement:
    • Treatment of the globe with or without concomitant whole-brain irradiation:
      • May be offered for vision preservation
  • Locoregional radiation therapy:
    • In the setting of widely metastatic disease:
      • Is not otherwise indicated
    • Chow E, Harris K, Fan G, Tsao M, Sze WM. Palliative radiotherapy for bone metastases: a systematic review. J Clin Oncol. 2007;25:1423-1436.
    • Kocher M, Soffietti R, Abacioglu U, et al. Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. J Clin Oncol. 2011;29:134-141.
    • Le Scodan R, Stevens D, Brain E, et al. Breast cancer with synchronous metastases: survival impact of exclusive locoregional radiotherapy. J Clin Oncol. 2009;27:1375-1381.
    • Ly BH, Nguyen NP, Vinh-Hung V, Rapiti E, Vlastos G. Loco-regional treatment in metastatic breast cancer patients: is there a survival benefit? Breast Cancer Res Treat. 2010;119:537-545.
    • Patchell RA, Tibbs PA, Regine WF, et al. Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA. 1998;280:1485-1489.

#Arrangoiz #BreastSurgeon #CancerSurgeon #BreastCancer #SurgicalOncologist #CenterforAdvancedSurgicalOncology #PalmettoGeneralHospital

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