Resected Brain Metastases
Radiation therapy is recommended for all patients following resection of brain metastases to improve intracranial control. For patients with limited brain metastases after resection, post-operative SRS is recommended over WBRT to preserve the patient’s neurocognitive function and quality of life.
SRS prior to brain metastasis resection is conditionally recommended as a potential alternative to post-operative SRS.
About the Guideline
The guideline was based on a systematic literature review of articles published through September 2020. The multidisciplinary task force included radiation, medical and neurosurgical oncologists, a radiation oncology resident, a medical physicist and a patient representative.
This guideline task force included representatives from the American Association of Neurological Surgeons/Congress of Neurological Surgeons, the American Society of Clinical Oncology (ASCO) and the Society of Neuro-Oncology (SNO). ASTRO, ASCO and SNO also published a joint guideline in 2021 with clinical recommendations for surgery and systemic therapy, as well as radiation therapy, for the multidisciplinary treatment of patients with brain metastases. The ASTRO guideline update in Practical Radiation Oncology is intended to be a complement to that joint guideline, to provide more comprehensive detail about radiation therapy.
ASTRO's clinical guidelines are intended as tools to promote appropriately individualized, shared decision-making between physicians and patients. None should be construed as strict or superseding the appropriately informed and considered judgments of individual physicians and patients.
ABOUT ASTRO
The American Society for Radiation Oncology (ASTRO) is the largest radiation oncology society in the world, with nearly 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies.
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