Fractionated stereotactic external beam radiotherapy in the management of brain metastases

Abstract

24 patients with 28 brain metastases were treated with fractionated stereotactic radiotherapy (SRT). Doses ranged from 10 Gy in two fractions to 20 Gy in two fractions. 13 patients received SRT boost after whole brain radiotherapy (WBRT), 5 were treated with SRT alone and 6 were treated at the time of recurrence following WBRT. The median progression-free survival at the treated site was 18 months and the median survival was 18 months. All patients were treated without admission to hospital. Toxicity of fractionated SRT was minimal and patients treated without WBRT did not suffer significant alopecia. Fractionated SRT offers a non-toxic non-invasive alternative to excision surgery in patients with solitary brain metastases. The optimum fractionation schedule and the role of whole brain irradiation remain to be determined.