Whole brain radiation is not usually used for GBMs now (unless they already spread throughout the brain), but has been the standard for cancers that spread to the brain. This article suggests that delaying radiation may lead to less loss of cognitive functioning. They used Gliadel wafer or stereotactic radiosurgery to slow down the recurrences.
A study led by researchers from Perelman School of Medicine at the University of Pennsylvania proves that 98% of patients who deferred whole brain radiation therapy and had chemotherapeutic wafers placed around the areas where metastatic tumors in the brain had been surgically removed showed preserved cognitive function in one or more of three domains. This study is published in Cancer. “While not denying the value of whole brain radiation therapy for select patients, the current study supports the growing trend for some patients to have surgery and local therapy to the tumor bed, via stereotactic radiosurgery or chemowafers”, said lead author Steven Brem, MD, professor of Neurosurgery at the Perelman School of Medicine. “We know that about half of patients with metastatic brain cancer go on to develop a new, separate brain metastasis, which can be detected by using surveillance MRI every 2 to 3 months. Some patients can go for years with normal brain function without risking the toxicity of whole brain radiation”. “We will continue to try to find interventions that preserve function while preserving or increasing the quality life for patients with cancer that spreads to their brain”, said Dr. Brem, noting that further studies comparing treatment options are needed to determine the optimal treatment strategy.