Would you offer post-operative SRS/SBRT in the case of a resected brain metastasis from metastatic NSCLC with an EGFR mutation?

Topics: Lung Cancer • Radiation Oncology • Neuro-Oncology • Brain Metastases

With targeted therapies available, is there a utility for post-op SRS to the resection cavity?

Answer from: Radiation Oncologist at Academic Institution

Absolutely. For symptomatic brain metastases, I would not rely on the efficacy of systemic therapy alone either in the intact or post-operative setting. CNS objective response rates are around 60% for osimertinib with DCR around 90% which is quite good. However, intracranial complete response rates ...

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Radiation Oncologist at Texas Oncology-Arlington Cancer Center North
Do you hold osimertinib while delivering RT? If so...

Answer from: Radiation Oncologist at Academic Institution

I agree. One reason is that after surgical resection, the vascularization of the surgical cavity is poor and drug penetration may be suboptimal.

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