How would you manage a patient with limited dural-based metastases?
Is SRS reasonable if there is no evidence of more diffuse disease?
Answer from: Radiation Oncologist at Community Practice
Pachymeningeal (dural) metastases come in 3 varieties – distinguishing these entities is important therapeutically.
Calvarial metastases with secondary pachymeningeal (dural) extension – these tumors can be thought of as bony metastases and can sometimes be monitored on systemic therapy...
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Answer from: Radiation Oncologist at Academic Institution
Dural-based metastases behave more like parenchymal brain metastases. These are not necessarily leptomeningeal in nature and do not need to be treated with whole-brain radiation. As such if limited in number, our approach has been to treat these with stereotactic radiosurgery if there is...