How do you manage brain mets involving the cavernous sinus?

I don’t recall seeing this and, sadly, that covers a lot of ground. SRS if you can avoid the chasm. Otherwise, fractionated.

I recently treated a patient with two simultaneous mets from carcinoid tumor to the meninges of the optic nerve sheath and the cavernous sinus. Both were treated in a single plan to 50.4 Gy fractionated, like I usually would for an optic nerve sheath meningioma.

By treatment end, the patient had a g...

Metastatic disease to cavernous sinus region is rare, but has been described in the literature.

Assuming the patient is a candidate for SRS, can consider delivering, in 5 fractions, 30 Gy as feasible to GTV, while underdosing PTV margin to a dose of 25 Gy while keeping optics structures within appro...