A Paradigm Shift in the Radiation Treatment of Brain Metastases

Abstract

Treatment for patients with brain metastases has been evolving towards increased use of stereotactic radiosurgical techniques. This paradigm shift is based on technological developments and increased understanding about the potential negative consequences of whole brain radiation therapy. In this editorial review, we discuss the background of these changes. We also outline the pros and cons of four major developments in the treatment of brain metastases: (1) stereotactic radiosurgery in lieu of whole brain radiation therapy; (2) fractionated radiosurgery; (3) radiosurgery to the post-operative tumor bed; and (4) radiosurgery to numerous brain metastases.