Brain metastasis

Abstract

Recent advances in the diagnosis, screening, and management of cancer patients have led to an increase in the prevalence of metastatic brain disease. These advances have challenged the historical role of whole brain radiation therapy (WBRT), as the gold standard therapy for this group of patients. In particular, SRS has risen as a mainstay in the treatment of these patients, as its safety and effectiveness have allowed it to extend the reach of local therapy both as adjuvant and/or definitive treatment of brain metastases. In this chapter we will discuss the biological basis for SRS use, the rationale for patient selection, and SRS applications in either oligometastatic disease as well as in patients with multiple brain metastatic lesions. Evidence supporting SRS's role as adjuvant or definitive therapy will also be discussed.