Treatment for Brain Metastases With Stereotactic Radiation vs Hippocampal-Avoidance Whole Brain Radiation: A Randomized Clinical Trial.

Ayal A Aizer¹, Kee-Young Shin², Paul J Catalano^2,3, Ivy Ricca¹, Marciana Johnson¹, Grant Benham¹, Kristin Roper^4,5, Beverly Spicer¹, Eileen Mann¹, Jennifer Nosker⁶, Michael W Parsons⁷, Mallika L Mendu⁸, Jaroslaw Hepel⁹, Fallon Chipidza^4,5, Monica Krishnan^4,5, Diana D Shi¹, Nayan Lamba¹, Itai Pashtan^4,5, Luke Peng^4,5, Brian Alexander¹⁰, Paul D Brown¹¹, Patrick Y Wen¹², Daphne A Haas-Kogan¹, Rifaquat Rahman¹, Shyam Tanguturi¹

¹Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts.

²Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts.

³Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

⁴Department of Radiation Oncology, Milford Regional Medical Center, Milford, Massachusetts.

⁵Department of Radiation Oncology, South Shore Health, Weymouth, Massachusetts.

⁶Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts.

⁷Department of Psychiatry, Massachusetts General Hospital, Boston.

⁸Population Health Services Organization, Mass General Brigham, Boston, Massachusetts.

⁹Department of Radiation Oncology, Rhode Island Hospital/Brown University, Providence.

¹⁰Valo Health, Lexington, Massachusetts.

¹¹Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.

¹²Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.

PubMed PMC DOI PDF

Abstract

IMPORTANCE: Brain metastases are common in patients with cancer, and radiation is often used for management. Among patients with more than 4 brain metastases, the effects of stereotactic radiation targeting only individual tumors, compared with whole brain radiation with hippocampal avoidance, which radiates both tumors and normal brain, remain unknown. OBJECTIVE: To determine whether stereotacti…

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