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Review
. 2018 Aug 14;5(3):90.
doi: 10.3390/medicines5030090.

The Expanding Role of Radiosurgery for Brain Metastases

Mark O'Beirn  1 , Helen Benghiat  2 , Sara Meade  3 , Geoff Heyes  4 , Vijay Sawlani  5 , Anthony Kong  6 , Andrew Hartley  7 , Paul Sanghera  8
Affiliations
Review

The Expanding Role of Radiosurgery for Brain Metastases

Mark O'Beirn et al. Medicines (Basel). .

Abstract

Stereotactic radiosurgery (SRS) has become increasingly important in the management of brain metastases due to improving systemic disease control and rising incidence. Initial trials demonstrated SRS with whole-brain radiotherapy (WBRT) improved local control rates compared with WBRT alone. Concerns with WBRT associated neurocognitive toxicity have contributed to a greater use of SRS alone, including for patients with multiple metastases and following surgical resection. Molecular information, targeted agents, and immunotherapy have also altered the landscape for the management of brain metastases. This review summarises current and emerging data on the role of SRS in the management of brain metastases.

Keywords: brain metastasis; immunotherapy; stereotactic radiosurgery (SRS); stereotactic radiotherapy (SRT); whole brain radiotherapy (WBRT).

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Conflict of interest statement

The authors currently undertake radiosurgery for brain metastases using Cyberknife.

Figures

Figure 1
Figure 1
Radiosurgery for patients with a single metastasis and a favourable prognosis is standard practice. The figure illustrates a single metastasis covered with a prescription dose of 21 Gy prescribed to the 70% isodose line using Cyberknife. Prior informed consent was obtained for use of these images.
Figure 2
Figure 2
Radiosurgery to multiple metastases. The patient was referred with a symptomatic left frontal lobe metastasis; however, there were 11 metastases in total, and it was possible to treat all within a single session. The blue outline indicates the 20 Gy isodose (minimum dose prescribed to the left frontal lobe metastasis). Prior informed consent has been obtained for use of these images.
See this image and copyright information in PMC

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