Brain Metastases: Intact and Postoperative Radiotherapy and Radiosurgery

For patients with brain metastases, radiotherapy management with stereotactic radiosurgery (SRS) and whole brain radiotherapy (WBRT) has evolved over the years, guided by results from randomized controlled trials. These prospective data support the increasing utilization of SRS, with deferral of WBRT, for most patients with a limited number of brain metastases and good performance status, in both the definitive and post-resection settings. We highlight the general principles of SRS target delineation, dosing, and constraints to organs at risk.