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

Topics: Radiation Oncology • Neuro-Oncology • Stereotactic Radiosurgery

Do you fractionate? Do you look at composite doses and/or apply any constraints given the limited data?

Answer from: Radiation Oncologist at Academic Institution

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 rec...

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Radiation Oncologist at University of Colorado School of Medicine
Are there any specific constraints you recommend b...

Answer from: Radiation Oncologist at Academic Institution

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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Radiation Oncologist at University Hospital Basel
I see your point on WBRT, but perhaps many of us a...

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