JRSBRT 10.3, p. 145-155 (PDF)

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Role of radiosurgery and laser interstitial thermal therapy in the management of brain metastasis and treatment complications
Carlin Chuck, Mazen Taman, Joseph Oldam, Elaina J Wang, Giovanni Kozel, Serenitie Buyse, Alice Lin, Hsien-Chung Chen and Clark C. Chen

Brain metastases (BMs) are the most common intracranial tumors and remain a major source of neurologic morbidity in patients with systemic cancer. Stereotactic radiosurgery (SRS) has become a cornerstone of treatment due to effectiveness in achieving local control while limiting neurocognitive toxicity. This review summarizes the contemporary role of SRS in the management of BMs, including dose and fractionation considerations, local and distant control, and the evolving use of pre-resection and post-resection radiosurgery. We also review radiation necrosis as a complication of SRS and laser interstitial thermal therapy (LITT) as a treatment option. Finally, we examine the emerging paradigm of LITT followed by consolidation SRS (LITT-cSRS) in the treatment of BM that recur after SRS (BMRS).

Keywords: stereotactic radiosurgery, radiation therapy, brain metastases, laser interstitial thermal therapy (LITT)