Alliance N0574 (NCCTG N0574)
N0574 showed that adding whole-brain radiotherapy to radiosurgery for a few brain metastases damages memory and thinking without lengthening life, and radiosurgery alone became the standard.
Overview
N0574 randomised 213 patients with one to three brain metastases to stereotactic radiosurgery alone or radiosurgery plus whole-brain radiotherapy. Cognitive deterioration at three months, the primary endpoint, occurred in 63.5 percent after radiosurgery alone and 91.7 percent after the combination; whole-brain treatment improved intracranial control but median survival did not differ (10.4 vs 7.4 months, not significant) (Brown and colleagues, JAMA 2016).
- 63.5 vs 91.7 out of 100 reached this endpoint at 3 months with Radiosurgery alone compared with Radiosurgery plus whole-brain radiotherapy; 28.2 fewer per 100.
- On this measure the first group did worse, not better.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: One to three brain metastases: stereotactic radiosurgery alone versus radiosurgery plus whole-brain radiotherapy. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
213 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Cognitive deterioration at 3 monthsprimary | Radiosurgery alone | 111 | 63.5% | - | - | - |
| Radiosurgery plus whole-brain radiotherapy | 102 | 91.7% |
Similar pages
not linked directly; found by shared links- TrialNRG CC001
Shares Whole-brain radiotherapy (WBRT), Brain and spinal cord tumours (all types), Metastatic cancer (cancer that has spread) and the tag radiation-wave2.
- TrialQUARTZ
Shares Whole-brain radiotherapy (WBRT), Brain and spinal cord tumours (all types) and the tag radiation-wave2.
- TrialCATNON (EORTC 26053-22054)
Shares Brain and spinal cord tumours (all types) and the tag radiation-wave2.
- TermRadiation necrosis (brain)
Shares Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS), Brain and spinal cord tumours (all types), Metastatic cancer (cancer that has spread).
- TermBrain metastases (intracranial disease)
Shares Stereotactic radiosurgery (SRS), Whole-brain radiotherapy (WBRT), Metastatic cancer (cancer that has spread).
- TermLeptomeningeal disease
Shares Whole-brain radiotherapy (WBRT), Metastatic cancer (cancer that has spread).
- TreatmentDabrafenib
Shares Brain and spinal cord tumours (all types), Metastatic cancer (cancer that has spread).