Whole Brain Radiation Therapy is More Harmful Than Beneficial for Small Brain Metastases

In the phase 3 NCCTG N0574 (Alliance) trial, patients with 1 to 3 small brain metastases were randomised to receive stereotactic radiosurgery (SRS) alone or SRS followed by whole brain radiation therapy (WBRT).

The primary endpoint of the trial was to determine the impact of SRS alone or with SRS combined with WBRT on cognitive progression. At 3 months, cognitive decline in the combination arm was 91.7% compared with 63.5% in the SRS-alone arm (P = .0007).

Presented by Jan Buckner, MD, Mayo Clinic, Rochester, MN, at ASCO 2015.