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Is there any role for SRS+WBRT for patients with a limited number of small brain metastases?  

In keeping with prior randomized trials, Alliance N0574 demonstrated that SRS+WBRT provides superior intracranial disease control but worsens QOL and neurocognitive abilities, without improving survival, compared to SRS alone for patients with good performance status and 1-3 brain metastases, none larger than 3 cm in max diameter. Should SRS+WBRT still be considered for patients with high DS-GPA, as suggested by a post-hoc analysis of JROSG 99-1, or in patients who may not adhere to the close surveillance regimen used in Alliance N0574?



Answer from: Radiation Oncologist at Academic Institution
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