Palliative Radiation for Brain Metastases

  • Nicholas S. Boehling
  • David C. Weksberg
  • Jiade J. Lu
  • Eric L. Chang
Part of the Medical Radiology book series (MEDRAD)


The brain is one of the most common sites of cancer metastasis. Approximately half of the patients who develop brain metastases will be diagnosed with a single metastatic lesion. Spread is through hematogenous dissemination commonly to the watershed area at the gray/white matter junction. Metastases follow blood supply with the most occurring in the supratentorial brain. Some histologies, notably small cell lung cancer, prostate and gastrointestinal cancers are commonly found in the cerebellum.


Gross Tumor Volume Gamma Knife Cribriform Plate Develop Brain Metastasis Leptomeningeal Carcinomatosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Andrews DW et al (2004) Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 363(9422):1665–1672CrossRefPubMedGoogle Scholar
  2. Aoyama H et al (2006) Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 295(21):2483–2491CrossRefPubMedGoogle Scholar
  3. Boehling N et al (2012) Stereotactic radiosurgery for brain metastases: current status and future directions. J Radiat Oncol 1(3):245–253CrossRefGoogle Scholar
  4. Chang EL et al (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol 10(11):1037–1044CrossRefPubMedGoogle Scholar
  5. Choi CY et al (2012) Stereotactic radiosurgery of the postoperative resection cavity for brain metastases: prospective evaluation of target margin on tumor control. Int J Radiat Oncol Biol Phys 84(2):336–342CrossRefPubMedGoogle Scholar
  6. Gaspar L et al (1997) Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37(4):745–751CrossRefPubMedGoogle Scholar
  7. Gaspar LE et al (2010) The role of whole brain radiation therapy in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol 96(1):17–32CrossRefPubMedGoogle Scholar
  8. Kalkanis SN et al (2010) The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol 96(1):33–43CrossRefPubMedGoogle Scholar
  9. Kocher M et al (2011) Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952–26001 study. J Clin Oncol 29(2):134–141CrossRefPubMedGoogle Scholar
  10. Linskey ME et al (2010) The role of stereotactic radiosurgery in the management of patients with newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol 96(1):45–68CrossRefPubMedGoogle Scholar
  11. Patchell RA et al (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322(8):494–500CrossRefPubMedGoogle Scholar
  12. Patchell RA et al (1998) Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 280(17): 1485–1489CrossRefPubMedGoogle Scholar
  13. Shaw E et al (2000) Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90–05. Int J Radiat Oncol Biol Phys 47(2):291–298CrossRefPubMedGoogle Scholar
  14. Sperduto PW et al (2012) Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol 30(4):419–425CrossRefPubMedGoogle Scholar
  15. Tsao MN et al (2012) Radiotherapeutic and surgical management for newly diagnosed brain metastasis(es): an American Society for Radiation Oncology evidence-based guideline. Pract Radiat Oncol 2(3):210–225CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Nicholas S. Boehling
    • 1
  • David C. Weksberg
    • 1
  • Jiade J. Lu
    • 2
  • Eric L. Chang
    • 3
  1. 1.Department of Radiation OncologyM.D. Anderson Cancer CenterHoustonUSA
  2. 2.Shanghai Proton and Heavy Ion CenterShanghaiChina
  3. 3.Department of Radiation OncologyUSC Keck School of MedicineLos AngelesUSA

Personalised recommendations