Stereotactic radiosurgery with and without whole-brain radiotherapy for newly diagnosed brain metastases

Expert Rev Neurother. 2005 Jul;5(4):487-95. doi: 10.1586/14737175.5.4.487.

Abstract

Brain metastases develop in 20-40% of cancer patients and can cause significant morbidity. In selected patients with one to three lesions, stereotactic radiosurgery may be used to improve local control. However, it is unclear whether whole-brain radiotherapy is necessary for all patients who are candidates for stereotactic radiosurgery. While whole-brain radiotherapy may improve the locoregional control of brain metastases, it may cause long-term side effects and may not improve overall survival in some patients. Its benefits should be evaluated in the context of risks of neurocognitive deterioration, either from whole-brain radiotherapy or from uncontrolled brain metastases, and the possible need for salvage treatments with the omission of initial whole-brain radiotherapy. For certain radioresistant brain metastases, the benefit of whole-brain radiotherapy to patients who have stereotactic radiosurgery is uncertain.

Publication types

  • Review

MeSH terms

  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / radiotherapy*
  • Brain Neoplasms / secondary
  • Brain Neoplasms / surgery*
  • Humans
  • Lung Neoplasms / pathology
  • Radiosurgery / methods*