Do you place asymptomatic patients being treated for brain metastasis with SRS on prophylactic steroids?

We do not use steroids routinely for asymptomatic patients being treated for brain metastases except if there is a concern based on anatomic location, volume, and/or presence of edema (e.g. adjacent to motor strip with significant edema, in or adjacent to brain stem, V12 brain receiving > or near 10...

At our institution, we typically do. Swelling is possible post SRS which can become symptomatic. We don't tend to keep patients very long on steroids. One of our popular regimens is dexamethasone 4 mg 2x/day X 4 days, then 2 mg 3x/day X 2 days, 2 mg 2x/day X 2 days, then 2 mg daily X 2 days, then st...

No