29 October 2008
Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]
Summary ,


GUIDELINE OBJECTIVE(S)M

* To evaluate if patients with confirmed single brain metastases should have surgical resection
* To evaluate if patients with single brain metastases undergoing surgical resection should receive adjuvant whole brain radiation therapy (WBRT)
* To evaluate the role of stereotactic radiosurgery in the management of patients with single brain metastases

TARGET POPULATION

Adults with confirmed cancer and a single brain metastasis

Note: This practice guideline does not apply to patients with metastatic lymphoma, small cell lung cancer, germ cell tumour, leukemia, or sarcoma.

INTERVENTIONS AND PRACTICES CONSIDERED

Management/Treatment

1. Whole brain radiation therapy (WBRT) versus WBRT plus surgery
2. Surgery plus WBRT versus surgery alone
3. WBRT with or without stereotactic radiosurgery (SRS)
4. SRS versus surgical resection
5. SRS with or without WBRT

MAJOR OUTCOMES CONSIDERED

* Survival
* Quality of life
* Local control of disease
* Adverse effects