ABSTRACT
This chapter reviews the issue of using whole-brain radiotherapy (WBRT) for selected patients, summarizes publications about the various WBRT and simultaneous integrated boost (SIB) prescriptions, and describes the delivery of WBRT and SIB in 5 fractions. WBRT has been shown to reduce the risk of local and distant recurrences of brain metastases when combined with stereotactic radiosurgery (SRS) compared to SRS alone. The chapter presents a discussion about the patients for whom the risk/benefit ratio may favor WBRT. Patients’ long-term risk of dementia from whole-brain radiotherapy rises with advancing age and better prognosis from their extracranial disease. A 5-fraction course of WBRT and SIB was selected at our center because it was more convenient for patients than longer courses, and it could be delivered during the second week of a 3-week cycle of chemotherapy without delaying the systemic therapy schedule. The acute side effects of WBRT and SIB are the same as would be expected from WBRT alone.
