Treatment of brain metastases in small cell lung cancer: Decision-making amongst a multidisciplinary panel of European experts

P.M. Putora, G.F. Fischer, M. Früh, R. Califano, C. Faivre-Finn, P. Van Houtte, F. McDonald, U. Nestle, R. Dziadziuszko, C. Le Pechoux, S. Ramella, J. Belderbos, B.J. Slotman, E.G.C. Troost, S. Peeters, J. Widder, C. Pöttgen, M. Reck, F. Blackhall, F. CappuzzoB. Besse, S. Novello, P. Garrido, E. Felip, M. O'Brien, L. Paz Ares, F. de Marinis, V. Westeel, D. De Ruysscher

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Brain metastases (BM) are common in patients with small cell lung cancer (SCLC). In recent years, the role of whole brain radiotherapy (WBRT) for brain metastases in lung cancer is being reevaluated, especially in the context of new systemic treatments available for SCLC. With this analysis, we investigate decision-making in SCLC patients with BM among European experts in medical oncology and radiation oncology.
Methods
We analyzed decision-making from 13 medical oncologists (selected by IASLC) and 13 radiation oncologists (selected by ESTRO) specialized in SCLC. Management strategies of individual experts were converted into decision trees and analyzed for consensus.
Results and conclusion
In asymptomatic patients, chemotherapy alone is the most commonly recommended first line treatment. In asymptomatic patients with limited volume of brain metastases, a higher preference for chemotherapy without WBRT among medical oncologists compared to radiation oncologists was observed.
For symptomatic patients, WBRT followed by chemotherapy was recommended most commonly. For limited extent of BM in symptomatic patients, some experts chose stereotactic radiotherapy as an alternative to WBRT.
Significant variation in clinical decision-making was observed among European SCLC experts for the first line treatment of patients with SCLC and BM.
Original languageEnglish
Pages (from-to)84-88
Number of pages5
JournalRadiotherapy and Oncology
Volume149
Early online date20 Apr 2020
DOIs
Publication statusPublished - 1 Aug 2020

Keywords

  • Brain metastases
  • Chemotherapy
  • Decision-making
  • Small cell lung cancer
  • Stereotactic radiotherapy
  • Whole brain radiotherapy

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre

Fingerprint

Dive into the research topics of 'Treatment of brain metastases in small cell lung cancer: Decision-making amongst a multidisciplinary panel of European experts'. Together they form a unique fingerprint.

Cite this