CNS carcinoma

Section editor
	Seema Nagpal, MD Stanford University Palo Alto, CA, USA LinkedIn

This page has regimens and guidelines that are not specific to any one type of cancer. For disease-specific regimens and guidelines, please go to the following pages:

• Breast cancer, CNS metastases
• Non-small cell lung cancer, CNS metastases

1 regimens on this page 1 variants on this page

Guidelines

Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any article published 5+ years ago to be for historical purposes, only.

ASCO

• 2022: Schiff et al. Radiation Therapy for Brain Metastases: ASCO Guideline Endorsement of ASTRO Guideline PubMed

ASCO/SNO/ASTRO

• 2021: Vogelbaum et al. Treatment for Brain Metastases PubMed

EANO/ESMO

• 2021: Le Rhun et al. EANO–ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours PubMed
• 2017: Le Rhun et al. EANO–ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with leptomeningeal metastasis from solid tumours PubMed

NCCN

• NCCN Guidelines - Central Nervous System Cancers

All lines of therapy

Whole brain irradiation

WBRT: Whole-Brain Radiation Therapy

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Knisely et al. 2007 (RTOG 0118)	2002-2004	Phase 3 (C)	Thalidomide & WBRT	Did not meet primary endpoint of OS

Radiotherapy

• Whole-brain irradiation 2.5 Gy fractions x 15 (total dose: 37.5 Gy)

One course

References

1. RTOG 0118: Knisely JP, Berkey B, Chakravarti A, Yung AW, Curran WJ Jr, Robins HI, Movsas B, Brachman DG, Henderson RH, Mehta MP. A phase III study of conventional radiation therapy plus thalidomide versus conventional radiation therapy for multiple brain metastases (RTOG 0118). Int J Radiat Oncol Biol Phys. 2008 May 1;71(1):79-86. Epub 2007 Dec 31. link to original article contains dosing details in abstract PubMed NCT00033254