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Does infra- versus supra- tentorial tumor location change your management strategy for the treatment of single brain metastases?
There are retrospective data (i.e. PMID 15072456) that seem to associate posterior fossa location with increased risk of leptomeningeal disease after surgery. Do you feel that this is a true association and does it impact your treatment recommendations? Also, if a patient has surgery for posterior fossa metastasis are you more apt to offer WBRT versus SRS boost considering this risk, and would you ever treat the posterior fossa alone?
Answer from: Radiation Oncologist at Community Practice
My experience has been that there is a greater risk of vasogenic edema after SRS to the posterior fossa due to the anatomical constraints. If there is marked mass effect from the lesion, I push the surgeons to resect followed by conformal XRT to the tumor bed. Otherwise, I have trea...
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