1 University of California, San Francisco, San Francisco, CA.
2 American Society of Clinical Oncology, Alexandria, VA.
J Clin Oncol. 2019 May 1;37(13):1130-1135. doi: 10.1200/JCO.18.02085. Epub 2019 Mar 18.
The Congress of Neurological Surgeons (CNS) has developed a series of guidelines for the treatment of adults with metastatic brain tumors, including systemic therapy and supportive care topics. ASCO has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations.
Two CNS guidelines were reviewed for developmental rigor by methodologists, and an independent multidisciplinary Expert Panel was formed to review the content and assess agreement with the recommendations. The Expert Panel voted to endorse the two guidelines, and ASCO and Society for Neuro-Oncology (SNO) independently reviewed and approved the ASCO/SNO guideline endorsement.
The ASCO/SNO Expert Panel determined that the recommendations from the CNS anticonvulsants and steroids guidelines, published January 9, 2019, are clear, thorough, and based on the most relevant scientific evidence. ASCO/SNO endorsed these two CNS guidelines with minor alterations.
Key recommendations include the following: prophylactic antiepileptic drugs were not recommended for routine use; and corticosteroids, specifically dexamethasone, were recommended for temporary symptomatic relief in patients with neurologic symptoms and signs related to mass effect from brain metastases. Additional information is available at www.asco.org/neurooncology-guidelines .
神经外科学会（CNS）针对成人脑转移瘤的治疗制定了一系列指南，包括系统治疗和支持性护理相关内容。美国临床肿瘤学会（ASCO）有一套认可由其他专业组织制定的临床实践指南的政策和程序。
方法学家对两项 CNS 指南进行了严格的开发审查，并成立了一个独立的多学科专家小组来审查内容并评估与建议的一致性。专家组投票赞成这两项指南，ASCO 和神经肿瘤学会（SNO）分别独立审查并批准了 ASCO/SNO 指南的认可。
ASCO/SNO 专家组确定，2019 年 1 月 9 日发布的 CNS 抗癫痫药物和皮质类固醇指南中的建议明确、全面，并基于最相关的科学证据。ASCO/SNO 对这两项 CNS 指南进行了轻微修改后表示认可。
主要建议包括：不建议常规使用预防性抗癫痫药物；推荐使用皮质类固醇，特别是地塞米松，用于有与脑转移瘤占位效应相关的神经症状和体征的患者，以暂时缓解症状。更多信息请访问 www.asco.org/neurooncology-guidelines。
