{{Short description|Treatment for cancer in the brain}} {{cs1 config|name-list-style=vanc|display-authors=6}} {{Infobox medical intervention | name = Whole brain radiotherapy | synonym = | image = | caption = | alt = | pronounce = | specialty = oncology | synonyms = | ICD10 = | ICD9 = | ICD9unlinked = | CPT = | MeshID = | LOINC = | other_codes = | MedlinePlus = | eMedicine = }} '''Whole brain radiotherapy''' (WBRT) is a treatment option for patients with brain metastases. In WBRT, radiation therapy is administered broadly, to the whole brain, over multiple treatments.<ref name="Garsa-2021" /> Another type of WBRT is Hippocampal-avoidance whole brain radiotherapy (HA-WBRT).<ref>{{Cite journal |last1=Woods |first1=Kaley |last2=Shen |first2=Zhilei Liu |last3=Xu |first3=Zhengzheng |last4=Zhang |first4=Hualin |last5=Natsuaki |first5=Yutaka |last6=Cheng |first6=Karen |last7=Li |first7=Vivian |last8=Kim |first8=Nathan |last9=Ma |first9=Lijun |last10=Chang |first10=Eric |date=2023-10-31 |title=Hippocampal sparing radiation therapy for brain metastases: treatment techniques and clinical implementation |url=https://cco.amegroups.org/article/view/118549 |journal=Chinese Clinical Oncology |language=en |volume=12 |issue=5 |pages=56 |doi=10.21037/cco-23-73 |pmid=37964545 |doi-access=free |issn=2304-3873}}</ref> HA-WBRT is an altered version of WBRT, where it is highly selective as to where the radiation dose is delivered by treating the whole brain while reducing the amount on the hippocampus.<ref>{{Cite report |url=https://effectivehealthcare.ahrq.gov/products/radiation-therapy-brain-metastases/research |title=Radiation Therapy for Brain Metasases |last1=Garsa |first1=Adam |last2=Jang |first2=Julie K. |last3=Baxi |first3=Sangita |last4=Chen |first4=Christine |last5=Akinniranye |first5=Olamigoke |last6=Hall |first6=Owen |last7=Larkin |first7=Jody |last8=Motala |first8=Aneesa |last9=Newberry |first9=Sydne |date=2021-06-09 |publisher=Agency for Healthcare Research and Quality (AHRQ) |doi=10.23970/ahrqepccer242|url-access=subscription }}</ref>
== Usage == WBRT has been shown to alleviate symptoms, decrease the use of corticosteroids needed to control tumor-associated edema, and potentially improve overall survival.<ref name="MyUser_Ncbi.nlm.nih.gov_August_20_2015c">{{cite journal | vauthors = McTyre E, Scott J, Chinnaiyan P | title = Whole brain radiotherapy for brain metastasis | journal = Surgical Neurology International | volume = 4 | issue = Suppl 4 | pages = S236–S244 | year = 2013 | pmid = 23717795 | pmc = 3656558 | doi = 10.4103/2152-7806.111301 | doi-access = free }}</ref> However, WBRT has been reported to increase the risk of cognitive decline.<ref name="MyUser_Medscape.com_August_20_2015c">{{cite web | vauthors = Johnson K | date = June 2015 |url=http://www.medscape.com/viewarticle/845758 |title=Whole-Brain Radiotherapy: Risks Worth Benefit? |newspaper=Medscape.com |access-date= August 20, 2015}}</ref> Additionally, single trials suggest that WBRT with memantine or hippocampal sparing may delay cognitive decline, though these methods did not improve survival or quality of life.<ref>{{Cite report |url=https://effectivehealthcare.ahrq.gov/products/radiation-therapy-brain-metastases/research |title=Radiation Therapy for Brain Metasases |last1=Garsa |first1=Adam |last2=Jang |first2=Julie K. |last3=Baxi |first3=Sangita |last4=Chen |first4=Christine |last5=Akinniranye |first5=Olamigoke |last6=Hall |first6=Owen |last7=Larkin |first7=Jody |last8=Motala |first8=Aneesa |last9=Newberry |first9=Sydne |date=2021-06-09 |publisher=Agency for Healthcare Research and Quality (AHRQ) |doi=10.23970/ahrqepccer242|url-access=subscription }}</ref>
WBRT may be administered in combination with stereotactic radiosurgery (SRS), surgery, or systemic therapies.<ref name="Garsa-2021" /> Based on data, WBRT combined with systemic therapies increased the likelihood of vomiting but overall, there were no other major differences regarding adverse events between these two treatment methods.<ref>{{Cite report |url=https://effectivehealthcare.ahrq.gov/products/radiation-therapy-brain-metastases/research |title=Radiation Therapy for Brain Metasases | vauthors = Garsa A, Jang JK, Baxi S, Chen C, Akinniranye O, Hall O, Larkin J, Motala A, Newberry S |last9=Newberry |first9=Sydne |date=2021-06-09 |publisher=Agency for Healthcare Research and Quality (AHRQ) |doi=10.23970/ahrqepccer242|url-access=subscription }}</ref> Memantine has been recommended for use by professional organization consensus to prevent neurocognitive decline after WBRT.<ref>{{cite journal | vauthors = Vogelbaum MA, Brown PD, Messersmith H, Brastianos PK, Burri S, Cahill D, Dunn IF, Gaspar LE, Gatson NT, Gondi V, Jordan JT, Lassman AB, Maues J, Mohile N, Redjal N, Stevens G, Sulman E, van den Bent M, Wallace HJ, Weinberg JS, Zadeh G, Schiff D | title = Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline | journal = Journal of Clinical Oncology | volume = 40 | issue = 5 | pages = 492–516 | date = February 2022 | pmid = 34932393 | doi = 10.1200/JCO.21.02314 | s2cid = 245385315 | doi-access = free }}</ref> While these can improve survival for some patients with single brain metastasis, a 2021 systematic review of the literature found inconsistent results for overall survival.<ref name="Garsa-2021">{{cite journal | title = Radiation Therapy for Brain Metastases | journal = Effective Health Care (EHC) Program | year = 2021 | pmid = 34152714 | doi = 10.23970/ahrqepccer242 | publisher = Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health & Human Services | s2cid = 236256085 | vauthors = Garsa A, Jang JK, Baxi S, Chen C, Akinniranye O, Hall O, Larkin J, Motala A, Newberry S, Hempel S }}</ref>
== References == {{Reflist}}
Category:Chemotherapy