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In response to Fogarty et al. and why adjuvant whole brain radiotherapy is not recommended routinely.

In response to Fogarty et al. and why adjuvant whole brain radiotherapy is not recommended routinely.
Author Information (click to view)

Pinkham MB, Sahgal A, Pullar AP, Foote MC,


Pinkham MB, Sahgal A, Pullar AP, Foote MC, (click to view)

Pinkham MB, Sahgal A, Pullar AP, Foote MC,

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BMC cancer 2017 11 1517(1) 768 doi 10.1186/s12885-017-3672-z
Abstract

The routine use of adjuvant whole brain radiotherapy (AWBRT) after surgery or stereotactic radiosurgery is now discouraged by a number of international expert panels. Three decades of randomised studies have shown that, although AWBRT improves radiological measures of intracranial disease control, the clinical benefit is unclear and it is also associated with inferior quality of life and neurocognitive function. The number of patients with melanoma in these trials was low, but data suggesting that treatment-related side effects should vary according to histology of the primary malignancy are lacking. For metastatic melanoma, the role of AWBRT to control microscopic disease in the brain is also a less relevant concern because systemic therapies with intracranial activity are now available. Whether AWBRT is useful in select patients deemed at high risk of neurologic death remains undefined.

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