Is stereotactic radiotherapy an effective treatment option for patients with brain metastasis?

Stereotactic radiotherapy (SRT) is a precise form of radiation that delivers high doses to tumors while sparing healthy tissue. For patients with brain metastases, SRT is a standard treatment option that provides excellent local control and minimizes damage to surrounding brain. Studies show that SRT achieves local control rates above 80% at one year, with low rates of serious side effects.

What the research says

A narrative review highlights that SRT is widely used due to its high precision, rapid dose fall-off, high local control rates, and superior preservation of neurocognitive function compared to whole-brain radiotherapy ⁴. An international multicenter study of brainstem metastases found that SRT and fractionated SRT achieved 12-month local control of 82.9% and 24-month local control of 71.4% ⁸. A phase 2 trial in breast cancer patients with brain metastases treated with fractionated SRT reported a 1-year local control rate of 88.6% and median overall survival of 29 months, with only 6.2% of lesions experiencing radiation necrosis ⁷. In head and neck squamous cell carcinoma patients with brain metastases, those receiving stereotactic radiosurgery had reduced mortality risk compared to no treatment ². For melanoma brain metastases, SRT is considered for 1-4 lesions and is being explored for up to 15 lesions, with improving outcomes ¹⁰. Overall, SRT is effective for a limited number of metastases and is often combined with other therapies.

What to ask your doctor

• How many brain metastases do I have, and am I a candidate for stereotactic radiotherapy?
• What are the expected local control rates and potential side effects for my specific type of cancer?
• Should I consider combining SRT with surgery or systemic therapy like immunotherapy or targeted drugs?
• What is the risk of radiation necrosis, and how would it be managed if it occurs?
• How will my cognitive function be monitored after treatment?