An update on radiation therapy for brain metastases

Radiation therapy (RT) is an important treatment modality for brain metastases. Recent clinical trials have established the role of stereotactic radiosurgery (SRS) in the improvement of local control of brain metastases. Prospective trial data confirmed the feasibility and efficacy of using SRS alone to treat 5 or more brain metastatic tumors. Besides tumor control, there is increased emphasis on quality of life and neurocognitive function preservation. The new approach of hippocampi-sparing whole brain RT has been tested in an attempt to minimize the neurocognitive toxicity of whole brain RT. There is now level 1 evidence to support the multidisciplinary approach of surgical resection of brain metastases followed by cavity SRS which has been shown to preserve neurocognitive function without compromising survival. The current review summarizes the recent advances in RT for brain metastases.