Brain Metastases

  • Balamurugan A. Vellayappan
  • Arjun Sahgal
  • Kristin J. Redmond
  • Lia M. Halasz
  • Eric L. Chang
  • Simon S. LoEmail author
Part of the Medical Radiology book series (MEDRAD)


Brain metastases (BM) cause significant morbidity and mortality, with profound personal and societal impact. Historically, surgery and whole-brain radiotherapy (WBRT) were the mainstays of management. WBRT alone has been shown to have limited role for durable local control, and there are concerns regarding its impact on quality of life (QoL) and neurocognitive function. Advances in systemic therapeutics have afforded improved control of extracranial disease and paved the way for improved survival outcomes. In parallel, the overarching goals of BM management are to provide durable intracranial control and good QoL, with minimal long-term toxicities, and, if possible, to prolong survival. However, there remain significant controversies within the oncology community about how these goals should be achieved. Herein, we will review various management strategies, including the role of stereotactic radiosurgery (SRS) and methods to mitigate long-term toxicity of WBRT.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Balamurugan A. Vellayappan
    • 1
  • Arjun Sahgal
    • 2
  • Kristin J. Redmond
    • 3
  • Lia M. Halasz
    • 4
  • Eric L. Chang
    • 5
  • Simon S. Lo
    • 6
    Email author
  1. 1.Department of Radiation OncologyNational University Cancer InstituteSingaporeSingapore
  2. 2.Department of Radiation OncologySunnybrook Health Sciences Center, University of TorontoTorontoCanada
  3. 3.Department of Radiation Oncology and Molecular Radiation SciencesJohns Hopkins UniversityBaltimoreUSA
  4. 4.Department of Radiation OncologyUniversity of Washington School of MedicineSeattleUSA
  5. 5.Department of Radiation OncologyUniversity of Southern CaliforniaLos AngelesUSA
  6. 6.Department of Radiation OncologyUniversity of Washington School of MedicineSeattleUSA

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