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How do you approach SRS reirradiation for brain metastases overlapping previous sites of SRS?

Do you fractionate? Do you look at composite doses and/or apply any constraints given the limited data?
2 Answers
Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Roswell Park Comprehensive Cancer Center
Answered on

This situation has several variants.

First of all its incidence should be about 5% in most SRS cases.

Second all retreatment decisions should be made following co-registration of current images with treatment images. Easy to be tricked based on scan angle.

Variant 1: Response followed by recurrence ...

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Mednet Member
Mednet Member
Radiation Oncology · University of Colorado School of Medicine
Answered on

This is not a common scenario, ie a new brain metastases so adjacent that there is overlap with a previously SRSed lesion. But if I am sure it is separate but beside a previously treated lesion, I would probably do SRS with usual dose. More commonly, there is an increase in size of the previously tr...

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