How would you approach treatment of a recurrent brainstem metastasis following prior SRS?  

Recurrent brainstem metastasis can be quite catastrophic. In the upfront setting, I recommend treating to an adequate tumoricidal dose (unfortunately I've seen folks back off significantly in the brainstem and this can result in lower LC rates). Having said that, should a recurrence occur, I would n...

As @Albert Attia has mentioned, recurrence/progression of an insufficiently treated metastasis in the brainstem is a very difficult predicament. I agree it is best to treat these lesions with a dose with a high probability of control. If the lesion is large enough that such a dose is worrisome ...