Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Role of Chemotherapy in the Management of Adults With Newly Diagnosed Metastatic Brain Tumors

Question 1: Should patients with brain metastases receive chemotherapy in addition to whole brain radiotherapy (WBRT) for the treatment of their brain metastases?

Target Population: This recommendation applies to adult patients with newly diagnosed brain metastases amenable to both chemotherapy and radiation treatment.

Recommendations: Level 1: Routine use of chemotherapy following SRS is not recommended. Level 2: SRS is recommended in combination with chemotherapy to improve overall survival and progression free survival in lung adenocarcinoma patients.

Question 2: Should patients with brain metastases receive chemotherapy in addition to stereotactic radiosurgery (SRS) for the treatment of their brain metastases?

Question 3: Should patients with brain metastases receive chemotherapy alone?

Recommendation: Level 1: Routine use of cytotoxic chemotherapy alone for brain metastases is not recommended as it has not been shown to increase overall survival.Please see the full-text version of this guideline (https://www.cns.org/guidelines/guidelines-treatment-adults-metastatic-brain-tumors/chapter_5) for the target population of each recommendation.