Radiotherapy for metastatic brain tumors.

Radiation therapy has been the most important treatment for patients with brain metastases. With the development of stereotactic irradiation, conventional radiotherapy is being employed less often. However, whole-brain radiation therapy (WBRT) is still the mainstay of treatment for multiple brain metastases. This article reviews the results of conventional radiotherapy for brain metastases, and discusses optimal treatment, including fractionation schedules and combination with stereotactic irradiation, and the effects on neurocognitive functions. The authors conclude that WBRT with 30 Gy in ten fractions is no longer optimal for every patient with multiple brain metastases. WBRT employing appropriate fractionation schedules with or without stereotactic boost should be considered, depending on the patient's condition, disease status, and expected period of life.