Stereotactic Radiation: New Standard for Brain Metastases

A recent study led by Ayal Aizer, MD, MHS, radiation oncologist at Mass General Brigham, strongly suggests that stereotactic radiation should be the new standard of care for patients with up to 20 brain metastases, replacing whole-brain radiation. The findings demonstrated a clear advantage for stereotactic radiation across multiple examined areas.

The study's comparator was hippocampal-sparing whole-brain radiation, a more advanced technique that protects memory areas, unlike traditional whole-brain radiation. This means the research compared two cutting-edge radiation methods, definitively concluding that stereotactic radiation is the superior approach for managing these patients.

While acknowledging the inherent variability among patients with brain metastases—due to differing primary cancers, disease burdens, and prior treatments—the core message remains: stereotactic radiation is worth the effort due to its patient benefits.

Although stereotactic radiation is more complex and nuanced than whole-brain radiation, the techniques used in the study are widely accessible. All patients in the study were treated using a linear accelerator, a common piece of equipment in radiation oncology clinics. While some infrastructure and expertise are required, the approach does not necessitate specialized or unique devices, making it broadly adoptable by most radiation oncology centers.