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Central nervous system cancers, version 2.2014. Featured updates to the NCCN Guidelines
Louis Burt Nabors1, Jana Portnow1, Mario Ammirati1
1From University of Alabama at Birmingham Comprehensive Cancer Center; City of Hope Comprehensive Cancer Center; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; The University of Texas MD Anderson Cancer Center; UCSF Helen Diller Family Comprehensive Cancer Center; University of Washington/Seattle Cancer Care Alliance; Memorial Sloan Kettering Cancer Center; Roswell Park Cancer Institute; Duke Cancer Institute; UC San Diego Moores Cancer Center; American Brain Tumor Association; University of Michigan Comprehensive Cancer Center; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; Massachusetts General Hospital Cancer Center; Vanderbilt-Ingram Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Stanford Comprehensive Cancer Center; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Huntsman Cancer Institute at the University of Utah; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Moffitt Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; and National Comprehensive Cancer Network.
The NCCN Guidelines for Central Nervous System Cancers now recommend stereotactic radiosurgery (SRS) for brain metastases based on total disease burden, not just lesion count. This update expands treatment options for patients with controlled, low-volume brain metastases.
Area of Science:
- Oncology
- Radiation Oncology
- Neurology
Background:
- The NCCN Guidelines for Central Nervous System Cancers offer multidisciplinary recommendations for patient care.
- Recent NCCN Guidelines Insights focus on updated management strategies for metastatic brain tumors.
Framework:
- The updated guidelines incorporate recent data on radiation therapy for brain metastases.
- The framework emphasizes a shift in treatment selection criteria for stereotactic radiosurgery (SRS).
Implementation:
- Stereotactic radiosurgery (SRS) is now considered for patients with more than 3 metastatic brain lesions.
- Treatment decisions for SRS are increasingly based on total disease burden rather than the number of lesions.
- SRS is becoming a standard component in managing patients with controlled, low-volume brain metastases.
Implications:
- This update may broaden patient eligibility for potentially curative radiation therapy.
- The revised approach aims to improve survival benefits by considering overall disease status.
- Enhanced management strategies for brain metastases can lead to better patient outcomes.
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