{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:19:57Z","timestamp":1789132797213,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2013,8,23]],"date-time":"2013-08-23T00:00:00Z","timestamp":1377216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Neurosurgical resection and whole\u2010brain radiation therapy (WBRT) are accepted treatments for single and oligometastatic cancer to the brain. To avoid the decline in neurocognitive function (NCF) linked to WBRT, the authors conducted a prospective, multicenter, phase 2 study to determine whether surgery and carmustine wafers (CW), while deferring WBRT, could preserve NCF and achieve local control (LC).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>NCF and LC were measured in 59 patients who underwent resection and received CW for a single (83%) or dominant (oligometastatic, 2 to 3 lesions) metastasis and received stereotactic radiosurgery (SRS) for tiny nodules not treated with resection plus CW. Preservation of NCF was defined as an improvement or a decline \u22641 standard deviation from baseline in 3 domains: memory, executive function, and fine motor skills, evaluated at 2\u2010month intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Significant improvements in executive function and memory occurred throughout the 1\u2010year follow\u2010up. Preservation or improvement of NCF occurred in all 3 domains for the majority of patients at each of the 2\u2010month intervals. NCF declined in only 1 patient. The chemowafers were well tolerated, and serious adverse events were reversible. There was local recurrence in 28% of the patients at 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Patients with brain metastases had improvements in their cognitive trajectory, especially memory and executive function, after treatment with resection plus CW. The rate of LC (78%) was comparable to historic rates of surgery with WBRT and superior to reports of WBRT alone. For patients who undergo resection for symptomatic or large\u2010volume metastasis or for tissue diagnosis, the addition of CW can be considered as an option. Cancer 2013;119:3830\u20133838. \u00a9 <jats:italic>2013 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.28307","type":"journal-article","created":{"date-parts":[[2013,8,23]],"date-time":"2013-08-23T14:30:54Z","timestamp":1377268254000},"page":"3830-3838","source":"Crossref","is-referenced-by-count":19,"title":["Preservation of neurocognitive function and local control of 1 to 3 brain metastases treated with surgery and carmustine wafers"],"prefix":"10.1002","volume":"119","author":[{"given":"Steven","family":"Brem","sequence":"first","affiliation":[{"name":"Department of Neuro\u2010Oncology Moffitt Cancer Center Tampa Florida"},{"name":"Department of Neurosurgery, Perelman School of Medicine University of Pennsylvania and the Abramson Cancer Center Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina A.","family":"Meyers","sequence":"additional","affiliation":[{"name":"Department of Neuro\u2010Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Medical Affairs Eisai Inc. 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