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How do you approach treatment of brainstem metastases in the setting of prior WBRT?

What dose/fractionation do you prefer for small vs large metastases?
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In how many sessions do you feel comfortable delivering SRS to a brainstem metastasis?

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1 Answer
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Radiation Oncology · Roswell Park Comprehensive Cancer Center
Answered on

Depending on the proximity of the WBRT the answer differs. If WBRT is more than 6 months prior I do not alter my prescription.

For more immediate WBRT - say as a post WBRT boost I keep the dose low to a conformal plan. 8-10 Gy single session and 15-18 in three fractions.

For our brainstem mets results...

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