Issn Print: 0163-2108

Publication Date: 2003/02/28


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To earn CME

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To earn CME credit, you must read the CME article and complete the quiz on the enclosed form, answering at least 70% of the quiz questions correctly. Select the best answer and place a check mark or an X mark in the corresponding space on the enclosed answer form. Do not fill in the answer box completely. Please indicate any name and address changes directly on the answer form. If your name and address do not appear on the answer form, please print that information in the blank space at the top left of the page. Make a photocopy of the completed answer form for your own files and mail the original answer form in the enclosed postage-paid business reply envelope by February 27, 2004. For more information, call (800) 787-8981.
Wolters Kluwer Health is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Wolters Kluwer Health designates this educational activity for a maximum of 1.5 category 1 credits toward the AMA’s Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the educational activity.
1. Contrast MRI has made CT (even with double-dose intravenous contrast) obsolete for the most sensitive detection of the presence and extent of central nervous system metastases.
True or False?
2. All patients with a known primary cancer who develop enhancing mass(es) in their brain should have a tissue diagnosis of their brain lesion before any therapy is initiated.
True or False?
3. Untreated, the average life expectancy of a patient with a symptomatic solid brain metastasis is only 1 to 2 months, and there is a 95% chance that the patient will die as a direct result of the brain metastasis.
True or False?
4. Fractionated whole-brain radiation therapy (WBRT) has been proved to increase the average life expectancy of patients with single brain metastases from 1 to 2 months (untreated) to 4 to 6 months, and it reduces the chance of dying from the brain tumor to approximately 50%.
True or False?
5. There are no concerns for adverse cognitive effects of WBRT given in 3-Gy fractions if the patient lives at least 1 year after radiation therapy.
True or False?
6. Microsurgical resection of brain metastases is to risky to consider for patients dying of cancer, and it remains controversial whether surgical resection can improve either the length of survival or the quality of life in patients with single brain metastases.
True or False?
7. Adding WBRT to microsurgical resection in patients who have had their single metastasis proven to be removed by postoperative MRI does not significantly reduce the risk of local recurrence in the resection cavity.
True or False?
8. Stereotactic radiosurgery can achieve similar survival and quality of life results as those achieved with microsurgery for patients with brain metastases, it is not limited by lesion location, and it can be used to treat multiple lesions in one setting.
True or False?
9. Stereotactic radiosurgery in addition to WBRT has not been proved to significantly improve the local control rate of up to four brain metastases in a prospective randomized clinical trial.
True or False?
10. Whether WBRT is a necessary addition to stereotactic radiosurgery in order to maximize local control of the treated lesion(s) is currently under study.
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