UC Irvine Medical Center


Tumors account for nearly 500,000 cases annually

Orange, Calif, Dec. 1, 2009 — A panel led by University of California, Irvine neurosurgeon Mark E. Linskey has developed the first formal evidence-linked national treatment guidelines to improve the quality of care for patients with brain metastases.

Dr. Mark E. Linskey

Brain metastases – tumors which travel to the brain from other parts of the body such as the breast and lung – account for nearly 500,000 new cancers each year in the U.S. Last year, the American Association of Neurological Surgeons and the Congress of Neurological Surgeons’ Joint Guidelines Committee, chaired by Linskey, assembled a 20-member panel of specialists in radiation oncology, medical- and neuro-oncology, and neurosurgery to work with the Evidence-Based Practice Center at McMaster University to develop formal evidence-linked treatment guidelines.

“This effort advances standard protocols for treating patients with brain metastases,” says Linskey, associate professor at UCI and Surgical Co-Director of the Neuro-Oncology Program at UC Irvine Medical Center. “By systematically analyzing the most promising and proven treatments according to strict evidence-based medicine criteria and distilling them into guidelines, we expect to greatly improve outcomes for patients being treated for brain metastases.”

Although technology and treatment options for brain metastases have improved in recent years, there has not been a standard, accepted way to treat these patients. Nor has there been a central source describing which treatment regimens are most successful. The goal, Linskey says, was to draw from the work of oncologists in multiple disciplines and analyze what works best and in which conditions. Linskey expects physicians around the word adopt the guidelines.

“Neuro-oncologists know how to treat these tumors, but we knew we could do so much better,” he says. The panel’s approach, developed in conjunction with the world-renowned McMaster Evidence-based Practice center, examined patient outcomes from the proliferation of new treatments available over the past 15 years, including surgical resection, stereotactic radiosurgery, whole brain radiation therapy, partial brain radiation, chemotherapy and various combinations of each.

The need for comprehensive guidelines is acute: Of the 1.4 million individuals with cancer in 2008, 30 to 40 percent will develop brain metastasis, compared to the approximately 17,000 new cases annually of cancers that originate in the brain.

“This is a significant improvement for patients,” Linskey says. “Tumors that spread to the brain touch just about every area of oncology.”

The new brain metastases guidelines include:

  • A range of therapeutic options for treating brain metastases;
  • The existing evidence used to guide decision-making and its limitations;
  • The range of diversity in practice patterns and the various demographic factors that influence clinical decisions; and
  • The impact of expert reviews of published clinical evidence on practice regarding treatment options for brain metastases.

“This research is incredibly up-to-date,” says Linskey, noting that the panel took just 12 months to collect and analyze the evidence. Members of the panel examined 25,000 studies and then utilized 400 of them to make their final guideline decisions.

The new guidelines will be published in a special issue of the Journal of Neuro-Oncology in December.

About UC Irvine Medical Center:  UC Irvine Medical Center is Orange County’s only university research hospital, Level I trauma center, American College of Surgeons-verified regional burn center and National Cancer Institute-designated comprehensive cancer center. It offers acute- and general-care service at its new 482,000-square-foot UC Irvine Douglas Hospital.

About the University of California, Irvine: UCI is a top-ranked university dedicated to research, scholarship and community service. Founded in 1965, UCI is among the fastest-growing University of California campuses, with more than 27,000 undergraduate and graduate students, 1,100 faculty and 9,200 staff. The top employer in dynamic Orange County, UCI contributes an annual economic impact of $4.2 billion. For more UCI news, visit www.today.uci.edu



John Murray