Whole-brain radiation therapy in breast cancer patients with brain metastases.
Over the past 10 years, improving the outcome of breast cancer patients with brain metastases has become an important challenge. The suboptimal results of whole-brain radiation therapy (WBRT) in these patients have led to the development of irradiation modalities with new technical and biological approaches. By ensuring better sparing of critical organs such as the hippocampus, highly conformal irradiation therapy may partially preserve long-term neurocognitive functions. An additional radiation boost to the tumor bed improves local control. Radiosensitizing agents and radioprotectors that modify response to radiation have also been designed to improve the efficacy of treatment or prevent neurological toxicity. This Review outlines the current strategies and novel developments in WBRT, with a particular focus on new irradiation modalities and experiences of radiosensitization.
Chargari
Cyrus
C
Medical and Radiation Oncology Unit Hôpital d'Instruction des Armées du Val-de-Grâce, 74 Boulevard de Port Royal, 75230 Paris Cedex 5, France. chargari-vdg@hotmail.fr
Campana
François
F
Pierga
Jean-Yves
JY
Védrine
Lionel
L
Ricard
Damien
D
Le Moulec
Sylvestre
S
Fourquet
Alain
A
Kirova
Youlia M
YM
D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D011837:Radiation-Protective Agents; D011838:Radiation-Sensitizing Agents; D016634:Radiosurgery; D050397:Radiotherapy, Intensity-Modulated / Q000295:instrumentation / Q000379:methods
D011837:Radiation-Protective Agents; D011838:Radiation-Sensitizing Agents