Laurie Gaspar, MD, professor and chair of the Department of Radiation Oncology, Grohne Chair in Clinical Oncology, University of Colorado School of Medicine, discusses the treatment of brain metastases in patients with lung cancer.

Gaspar says upwards of 50% of patients with either small cell lung cancer or non-small cell lung cancer will develop brain metastases throughout the course of their disease.

In small cell lung cancer, Gaspar says, there have been studies that have shown that prophylactic cranial radiation reduces the probability of brain metastases. However, many studies had to be combined in order to get a statistically significant figure and only 5% of patients saw improvement at 3 years.

Gaspar says that these findings make it worth discussing the option with these patients.

A study on prophylactic cranial radiation in non-small cell lung cancer did not accrue well, Gaspar says, and the results showed that it did not improve survival. Because of this, Gaspar believes that the idea to study prophylactic cranial radiation will not be resurrected.

Gaspar says that the use of whole-brain radiation therapy for established brain metastases is declining because there is an increase in interest in local treatment, such as radiosurgery. However, radiosurgery does not prevent new metastases from forming and patients must be kept under general surveillance with MRIs.

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Dr. Gaspar on Treating Brain Metastases in Lung Cancer

Laurie Gaspar, MD, Professor and Chair Department of Radiation Oncology, Grohne Chair in Clinical Oncology, University of Colorado School of Medicine, discusses reducing neurotoxicity in small cell lung cancer patients.

Neurotoxicity is a phenomenon, Gaspar says, that occurs with prophylactic cranial radiation or whole brain radiation therapy for brain metastases.

Gaspar says that there are several methods of decreasing neurotoxicity but that she is particularly interested in using medication to decrease the risk.

While using medication seems to be the most straightforward approach, additional research will focus on reducing or avoiding radiation to the hippocampus, Gaspar says. Protecting the hippocampus will help patients keep their memory.

As more patients with limited small cell lung cancer are being cured, quality of life is going to become increasingly important.

Laurie Gaspar, MD

Articles

Dr. Gaspar on Treating Brain Metastases in Lung Cancer

Dr. Gaspar on Reducing Neurotoxicity in Lung Cancer