The Side Effects of Whole Brain Radiation Therapy for Brain Metastases May Outweigh the Benefits for Some Patients

ASCO Annual Meeting
May 31, 2015

In a recent study, researchers found that radiation therapy to the whole brain after radiosurgery for cancer that has spread to the brain causes more thought and memory problems than just radiosurgery. Even though the additional radiation therapy controlled the cancer’s growth, it did not lengthen patients’ lives.

Radiosurgery is a type of radiation therapy that aims radiation directly and only to the parts of the brain where there is cancer. It is a common way to treat brain metastases when there are just a few areas where the cancer has spread. Regular surgery to remove the metastases is only an option for a few patients because of the risk of damage to the brain. At some point, most patients with brain metastases receive radiation therapy to the whole brain to control the cancer’s growth or reduce symptoms caused by the cancer.

As part of this study, 213 patients received either radiosurgery alone or radiosurgery followed by radiation therapy to the whole brain. All patients had one to three small brain metastases. After three months, researchers found that more patients who received radiation therapy to the whole brain had thought and memory problems than those who just received radiosurgery alone (92% compared with 64%).

What this means for patients

“We used to offer whole brain radiation early on, but now we know that the side effects of this therapy are worse for the patient than cancer growth or recurrences in the brain,” said senior study author Jan C. Buckner, MD, a professor of oncology at Mayo Clinic in Rochester, MN. “We expect that practice will shift to reserve the use of whole brain radiation therapy for later treatment and palliative care.”

Radiation therapy to the whole brain may still be an appropriate option for patients. Talk with your doctor about the goals of treatment, in addition to your treatment options.

Questions to ask your doctor

  • What type of cancer do I have? What does this mean?
  • Has the cancer spread anywhere else?
  • What are my treatment options?
  • What are the goals of treatment? Is it to eliminate the cancer, help me feel better, or both?
  • What are the side effects of each treatment?

More Information

What is Radiation Therapy?

What is Cancer Surgery?