Radiation Oncology/Palliation/Brain Metastases/Guidelines

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Brain Metastases Official Guidelines


National Comprehensive Cancer Network (NCCN)


American College of Radiology (ACR)


American Association of Neurologic Surgeons (AANS) / Congress of Neurologic Surgeons (CNS)

  • Steroids; 2010 PMID 19957014 -- "The role of steroids in the management of brain metastases: a systematic review and evidence-based clinical practice guideline." (Ryken TC, J Neurooncol. 2010 Jan;96(1):103-14. Epub 2009 Dec 3.)
  • Anticonvulsants; 2010 PMID 19957015 -- "The role of prophylactic anticonvulsants in the management of brain metastases: a systematic review and evidence-based clinical practice guideline." (Mikkelsen T, J Neurooncol. 2010 Jan;96(1):97-102. Epub 2009 Dec 3.)
  • Surgery; 2010 PMID 19960230 -- "The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline." (Kalkanis SN, J Neurooncol. 2010 Jan;96(1):33-43. Epub 2009 Dec 4.)
  • WBRT; 2010 PMID 19960231 -- "The role of whole brain radiation therapy in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline." (Gaspar LE, J Neurooncol. 2010 Jan;96(1):17-32. Epub 2009 Dec 4.)
  • SRS; 2010 PMID 19960227 -- "The role of stereotactic radiosurgery in the management of patients with newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline." (Linskey ME, J Neurooncol. 2010 Jan;96(1):45-68. Epub 2009 Dec 4.)
  • Chemotherapy; 2010 PMID 19960229 -- "The role of chemotherapy in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline." (Mehta MP, J Neurooncol. 2010 Jan;96(1):71-83. Epub 2009 Dec 4. Review.)
  • Retreatment; 2010 PMID 19957016 -- "The role of retreatment in the management of recurrent/progressive brain metastases: a systematic review and evidence-based clinical practice guideline." (Ammirati M, J Neurooncol. 2010 Jan;96(1):85-96. Epub 2009 Dec 3.)
  • Investigational therapies; 2010 PMID 19957013 -- "The role of emerging and investigational therapies for metastatic brain tumors: a systematic review and evidence-based clinical practice guideline of selected topics." (Olson JJ, J Neurooncol. 2010 Jan;96(1):115-42. Epub 2009 Dec 3.)


American Society for Radiation Oncology (ASTRO)

  • 2012 No PMID yet [1] [2] -- "Radiotherapeutic and surgical management for newly diagnosed brain metastasis/es: An American Society for Radiation Oncology evidence-based guideline (2012)" (Tsao M, Practical Radiation Oncology 2012 -- online before print)
  • 2005 (Review) - PMID 16111570 — "The American Society for Therapeutic Radiology and Oncology (ASTRO) evidence-based review of the role of radiosurgery for brain metastases." Mehta MP et al. Int J Radiat Oncol Biol Phys. 2005 Sep 1;63(1):37-46.


Cancer Care Ontario


European Federation of Neurological Societies (EFNS)


International RadioSurgery Association (IRSA)


German Society of Radiation Oncology (DEGRO)

  • Brain Metastases and Leptomeningeal Carcinomatosis (2010) PMID 20127222 -- "DEGRO Practical Guidelines for Palliative Radiotherapy of Breast Cancer Patients: Brain Metastases and Leptomeningeal Carcinomatosis." (Feyer P, Strahlenther Onkol. 2010 Feb;186(2):63-69. Epub 2010 Jan 26.)
    • Conclusion: RT is an effective tool for palliative treatment of brain metastases and leptomeningeal carcinomatosis


Driving Restrictions: