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Radiation Oncology • Stereotactic Radiosurgery
Do you routinely offer a stereotactic boost to patients with bulky (>3cm) residual brain metastasis after whole brain radiation for multiple brain metastases?
Do you adjust your dose based on previous whole brain radiation? What time interval would you wait following whole brain or would you treat with upfront SRS?
Answer from: Radiation Oncologist at Academic Institution
In general, bulky tumors are resected out. If for some reason a patient with a bulky tumor does receive WBRT for a bulky tumor, I would wait a month or two after for a repeat MRI. If the tumor does shrink it should provide some room to dose escalate.
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