The Treatment Plan of Brain Metastases with Stereotactic Radiosurgery

Brain metastases represent the most frequent brain tumor and are a significant cause of morbidity and mortality. Surgery, whole brain radiation treatment (WBRT), and stereotactic radiosurgery (SRS) are all used in the treatment of brain metastases. Radiosurgery has emerged as a common treatment modality for brain metastases since the introduction of Gamma Knife (GK), but now advances in technology permits newer techniques, such as Cyberknife and linear accelerator (LINAC)-based. Stereotactic radiosurgery (SRS) treats brain tumors with a precise delivery of a single, high dose of radiation to a specific area of the brain in a one-day session. From literature it is well-known the potential benefits of SRS such as a short treatment time, a high probability of treated-lesion control and, regarding dose/volume recommendations, a low normal tissue complication probability. In this work will be presented some treatment plans realized for patients with 1-3 metastases in small volumes. Plans are performed by using Arc therapy with photon beams. Dosimetric parameters analyzed include the target dose-coverage, RTOG conformity index and 12 Gy isodose volume V (12Gy) for each target. The physical parameters state that are sufficient for plan evaluation and assessment to clinical complications in radiosurgery for brain metastases.