Defining patterns of care in the management of patients with brain metastases in a large oncology centre: A single-centre retrospective audit of 236 cases

Eur J Cancer Care (Engl). 2019 Jul;28(4):e13059. doi: 10.1111/ecc.13059. Epub 2019 Apr 16.

Abstract

Aims: The role of selected treatments for brain metastases (BM) is well documented; however, the prevalence of these is not. We report on the patterns of care in the management of BM in a large oncology centre.

Materials and methods: We retrospectively audited 236 cases of newly diagnosed BM from January 2016 to December 2017 by looking at 2 years of radiology reports and gathered data on primary site, survival, treatment received, palliative care input and brain metastases-related admissions.

Results: Eighty-two per cent of cases were related to lung, breast and melanoma primaries. Half of patients received a form of treatment with the other half receiving best supportive care. Of these, whole-brain radiotherapy (39%) and stereotactic radiosurgery (40%) were the most common treatment modalities. Most common reasons for admissions were headaches, seizures, weakness and confusion.

Conclusion: This is the first study in the UK that gives an in-depth overview of the real-world management of brain metastases. We have demonstrated the prevalence of treatment across the spectrum of brain metastases patients. Radiotherapy is the mainstay of treatment in nearly 80% of cases; however, care needs to be taken in ensuring that SRS is offered to those who are suitable.

Keywords: brain metastases; multidisciplinary working; palliative care; stereotactic radiosurgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / mortality
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / therapy
  • Breast Neoplasms / mortality
  • Cancer Care Facilities
  • Female
  • Humans
  • Lung Neoplasms / mortality
  • Male
  • Melanoma / mortality
  • Middle Aged
  • Palliative Care / statistics & numerical data
  • Radiosurgery / statistics & numerical data
  • Retrospective Studies
  • Skin Neoplasms / mortality
  • Whole-Body Irradiation / statistics & numerical data