Should hippocampal-avoidance WBRT be the default option for WBRT?

I think this is a difficult question to answer as a lot depends on the particulars. Here's a list of some of those issues:

1. Radiosurgery is very easily administered & frequently free of toxicity.
2. Systemic agents are showing improved efficacy in the brain.
3. Surveillance MR imaging = lower incidence of ...

I use hippocampal avoidance whenever possible. The best strategy to avoid/prevent radiation complications is not to use it. In the same concept, minimizing the dose to any normal structures or ALARA should always be exercised.