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Radiation Oncology • Neuro-Oncology
Would you treat an enlarging metastasis of the brainstem/upper cervical spinal cord with SRS in the setting of widespread disease and prior WBRT?
The patient presents with worsening nausea in the setting of a ~2-3 cm metastasis at the junction of the brainstem and spinal cord, s/p WBRT for ES-SCLC one year prior. The patient has >40 brain lesions.
If you were to treat, what dose and fractionation scheme would you use for this region? 25 Gy in 5 fractions?
Answer from: Radiation Oncologist at Academic Institution
From what I understand, this is a patient with extensive-stage SCLC and widespread intracranial disease (>40 brain metastases), previously treated with WBRT (presumably 30 Gy in 10 fractions?), now presenting with a symptomatic (~2–3 cm) enlarging lesion at the brainstem/upper cervical spin...
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