Treatment for Brain Metastases With Stereotactic Radiation vs Hippocampal-Avoidance Whole Brain Radiation

Among patients with 5 to 20 brain metastases, does stereotactic radiation targeting individual tumors reduce symptom burden and interference with daily function compared with hippocampal-avoidance whole brain radiation?In this randomized clinical trial of 196 patients, mean composite MD Anderson Symptom Inventory–Brain Tumor score (average of symptom severity and interference after baseline minus baseline; score range, −10 to 10; −10 = best) was −0.32 for stereotactic radiation and 0.74 for hippocampal-avoidance whole brain radiation (mean difference, −1.06).Stereotactic radiation improved symptoms and interference, key components of quality of life, compared with hippocampal-avoidance whole brain radiation in patients with 5 to 20 brain metastases.

Corresponding Author: Ayal A. Aizer, MD, MHS, Brigham and Women’s Hospital/Dana-Farber Cancer Institute, 75 Francis St, Boston, MA 02115 (aaaizer@mgb.org).

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