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Confusing Terminology in Medical Journal Articles

Adjuvant Treatment

Adjuvant treatment for brain metastases is treatment given to prevent a recurrence. It follows directly after the primary treatment (treatment for a brain metastasis). An example of an adjuvant treatment is whole-brain radiation after surgery or stereotactic radiosurgery. The surgery or radiosurgery treat the existing brain metastases and the whole-brain radiation therapy is given immediately after to prevent or reduce the chances of a recurrence. It is the opposite of what is referred to as “salvage” treatment (see below).

Encephalopathy

Literally a “disease of the brain,” a non-specific term. In articles about brain metastasis, it generally refers to a condition in the brain that can be caused by radiation or chemotherapy, usually occurring anywhere from 6 months to 2 years after radiation. Encephalopathy cause dementia and other neurological symptoms.

Intrathecal Chemotherapy

Intrathecal Chemotherapy delivers chemotherapy directly into the cerebrospinal fluid which surrounds the brain and spine. It can be given via a Ommaya Reservoir inserted on top of the head or as an injection into the lumbar spine. It is used for leptomeningeal metastases.

Local and Distant Recurrence

A local recurrence of a brain metastasis refers to a metastasis coming back in the same place. A distant recurrence refers to a metastasis coming back in another part of the brain.

Recursive Partitioning

Since treatment for brain metastases is often determined by a patient’s prognosis, recursive partitioning is used in research and clinical trials to see which treatments are the best for patients with different prognoses. Examples of factors considered for recursive partitioning are: multiple vs. single brain metastases, controlled vs. uncontrolled disease in other organs, solitary brain metastases vs. metastases in other organs, age, etc.

Salvage Treatment

This term refers to treatment that is held off until there is a recurrence. An example would be that you hold off doing whole-brain radiation after radiosurgery or surgery until there is a recurrence instead of doing it to prevent a recurrence.

(Please send us any words or concepts you don’t understand so we can define it for you and others)