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Indications for Stereotactic Radiosurgery: Multiple Brain Metastases

  • Anurag Saraf
  • Tony J. C. WangEmail author
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Abstract

Brain metastasis (BM) is the most common intracranial malignancy, and most patients present with multiple brain metastases at time of diagnosis. Whole brain radiation therapy (WBRT) has been the standard of care for multiple BM; however, recent studies have shown that stereotactic radiosurgery (SRS) may have similar outcomes and better toxicity profile than WBRT in the setting of multiple BM.

SRS has worse distant brain failure for patients with multiple BM than with the addition of WBRT. However, with frequent follow-up and surveillance imaging for salvage treatment (with SRS, surgery, or WBRT), studies find that SRS has similar overall survival to WBRT in the treatment of multiple BM. On the other hand, WBRT leads to worsening neurocognitive decline and worse quality of life and, therefore, the toxicity profile may not be an appropriate choice for patients compared to SRS alone.

Keywords

Brain metastases Radiation therapy Stereotactic radiosurgery Whole brain radiation therapy Radiation necrosis Neurocognition Gamma Knife stereotactic radiosurgery Cyberknife radiosurgery 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Radiation OncologyMassachusetts General HospitalBostonUSA
  2. 2.Department of Radiation OncologyColumbia University Irving Medical CenterNew YorkUSA

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