New treatment guidelines for patients with brain metastases are now available from the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS). David Andrews, M.D., F.A.C.S., professor and vice-chair of Clinical Services in the Department of Neurological Surgery at Jefferson Hospital for Neuroscience, served as a member of the task force chosen to draft this new, significant tool to improve the quality of care for patients who suffer from brain tumors. The nation's neurosurgeons took the lead in drafting the first national evidence-based, multidisciplinary guidelines for these types of patients, which account for nearly 500,000 new cancers in the United States. Brain metastases are tumors which travel to the brain from other areas of the body, usually the breast or lung, and outnumber all other brain tumors combined by more than four to one.
The guidelines were developed over the last year by a 20-member panel in various specialties in conjunction with the McMaster Evidence-based Practice Center, which is world-renowned for its seminal work in evidence-based medicine (EBM). The formal EBM process involved reviewing the literature and reaching a multidisciplinary consensus for different treatments. Unlike previous formal expert consensus efforts, recommendations are directly linked to levels of evidence in a transparent and reproducible methodology. Members of the panel analyzed 25,000 studies and then utilized 400 of them to make their final guideline decisions.
"A decade ago, a brain metastasis diagnosis was a death sentence. But advancements in technology and treatment like surgical resection, stereotactic radiosurgery, whole brain radiation therapy, partial brain radiation and chemotherapy, now allow for better patient outcomes," said Dr. Andrews. "Until now, there has been no formally adopted way to treat these patients. Physicians also lacked a critical central resource of treatment regimens offering the best results. These new evidence-based guidelines offer us the opportunity to discuss with our patients the best available treatment option for them."