Stereotactic Radiosurgery for >5 Brain Metastases

Stereotactic radiosurgery (SRS) is a safe and effective treatment option for multiple brain metastases, offering the advantage of sparing global brain tissue over whole-brain radiotherapy. This chapter reviews the evidence supporting use of SRS in treating cases with more than five brain metastases. Rather than the number of tumors, the total tumor volume is a more important limiting factor. As technologies improve, treating a greater number of tumors has become more efficient. The tumor histology and biology as well as the availabilities of brain-penetrant systemic therapies are additional considerations in the ability to manage high intracranial tumor burden via the targeted radiosurgery approach successfully.