How do you approach the use of whole brain radiotherapy in a patient who has previously received 2 or more courses of SRS to overlapping sites?  

In light of lack of evidence otherwise, I am hesitant to modify my treatment dose or field in a patient who received SRS and received SRS again to the same site for failure, that now needs WBRT for recurrent local or distant brain disease.  What is clear is that when doing so, there is anecdota...