EFNS guidelines on diagnosis and treatment of brain metastases: report of an EFNS Task Force.
EFNS guidelines on diagnosis and treatment of brain metastases: report of an EFNS Task Force.
29 October 2008
European Federation of Neurological Societies - Medical Specialty Society
Summary , Pubmed ,
GUIDELINE OBJECTIVE(S)
To establish evidence-based guidelines and identify controversies regarding the management of patients with brain metastases
TARGET POPULATION
Patients with brain metastases
INTERVENTIONS AND PRACTICES CONSIDERED
Diagnosis/Evaluation
1. Medical history and physical examination
2. Computed tomography (CT) or magnetic resonance imaging (MRI)
3. Tissue diagnosis/histopathologic studies (by stereotactic or open surgery) if needed
4. Fluorodeoxyglucose positron-emission tomography (FDG PET) for detecting the primary tumor
5. Electroencephalogram (EEG)
6. CT of the chest/abdomen and mammography
7. Cerebrospinal fluid cytology if indicated
Management/Treatment
1. Surgical resection
2. Stereotactic radiosurgery (SRS)
3. Whole-brain radiotherapy (adjuvant or alone)
4. Chemotherapy
5. Supportive care (dexamethasone, anticonvulsants in patients with seizures, low-molecular-weight heparin (LMWH) in patients with venous thromboembolism (VTE)
MAJOR OUTCOMES CONSIDERED
* Sensitivity and specificity of diagnostic tests
* Effectiveness of treatment in improving median and overall survival, local tumor control, and functional independence and reducing relapse rate
European Federation of Neurological Societies - Medical Specialty Society
Summary , Pubmed ,
GUIDELINE OBJECTIVE(S)To establish evidence-based guidelines and identify controversies regarding the management of patients with brain metastases
TARGET POPULATION
Patients with brain metastases
INTERVENTIONS AND PRACTICES CONSIDERED
Diagnosis/Evaluation
1. Medical history and physical examination
2. Computed tomography (CT) or magnetic resonance imaging (MRI)
3. Tissue diagnosis/histopathologic studies (by stereotactic or open surgery) if needed
4. Fluorodeoxyglucose positron-emission tomography (FDG PET) for detecting the primary tumor
5. Electroencephalogram (EEG)
6. CT of the chest/abdomen and mammography
7. Cerebrospinal fluid cytology if indicated
Management/Treatment
1. Surgical resection
2. Stereotactic radiosurgery (SRS)
3. Whole-brain radiotherapy (adjuvant or alone)
4. Chemotherapy
5. Supportive care (dexamethasone, anticonvulsants in patients with seizures, low-molecular-weight heparin (LMWH) in patients with venous thromboembolism (VTE)
MAJOR OUTCOMES CONSIDERED
* Sensitivity and specificity of diagnostic tests
* Effectiveness of treatment in improving median and overall survival, local tumor control, and functional independence and reducing relapse rate
