ABSTRACT
Image-guided hypofractionated stereotactic radiation therapy (HSRT) has been used for the treatment of brain metastases. HSRT differs from commonly employed methods for delivering stereotactic radiosurgery (SRS) in the use of noninvasive immobilization and in the delivery of fractionated courses of radiation. SRS has been utilized to deliver targeted high-dose radiation to intact and resected brain metastases, minimizing dose to surrounding normal brain tissue, and potentially resulting in less adverse neurocognitive effects than whole-brain radiation therapy. Multiple randomized trials have been conducted to establish the appropriate roles of surgery and radiation therapy in management of brain metastases. Single-fraction SRS remains a reasonable option for tumors that are small and in noneloquent areas of the brain. Universally high rates of treated metastasis control have been reported with the use of HSRT for intact brain metastases. The reported rates of treated metastasis control and surgical bed control are high and consistent with those reported for patients with brain metastases treated with single-fraction SRS.
