Radiotherapy in patients with brain metastases - state of the art

Brain metastases are often a complication of advanced systemic cancer and remain the most common intracranial tumour type. In patients with previously diagnosed cancer, 10-30% will develop brain metastases. While patients typically present with non-specific symptoms, the most frequently findings include weakness, impaired balance, headaches, and seizures. Breast cancer is the most common source of brain metastases in women, and lung cancer in men. MRI has high sensitivity to detect secondary brain tumours. Current approaches to the management of brain metastases are driven by prognostic factors, including patients' preformanceperformance status, number of metastases, patients' age, and status of systemic disease. A cCombination of surgery, stereotactic radiosurgery (SRS), and whole brain radiotherapy (WBRT) offer the best outcomes. The only palliative WBRT is an important treatment modality for patients with multiple brain metastases and contraindications to surgery and SRS. Palliative WBRT is effective and improves quality of life of patients with brain metastasis.