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Initial management of brain metastases from EGFR-positive NSCLC

Initial management of brain metastases from EGFR-positive NSCLC

For patients who are frail or prefer to avoid aggressive treatment, supportive care alone is an alternative option.

This algorithm applies to NSCLCs that contain characteristic mutations in EGFR, exon 19 deletions, or exon 21 L858R mutations.

EGFR: epidermal growth factor receptor; NSCLC: non-small cell lung cancer; SRS: stereotactic radiosurgery; WBRT: whole-brain radiotherapy.

* For patients with a solitary brain metastasis, surgical resection may improve survival and may be an alternative option. Refer to the UpToDate discussion on oligometastatic disease and brain metastases.

¶ SRS is preferred over WBRT, when feasible. SRS versus WBRT is discussed in detail in the UpToDate overview discussion on treatment of brain metastases.
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