Radiosurgery for brain metastases.

We discuss the current literature on the role of stereotactic radiosurgery in the multidisciplinary management of brain metastases and focus on the level of evidence that addresses key management questions. We reviewed the literature on the different roles of radiosurgery, radiotherapy, and resection, and in particular the 2009 Guidelines project of the Joint Section on Tumors of the AANS/CNS. Retrospective case series, matched cohort studies, and randomized trials show specific survival and local tumor control benefits after radiosurgery. Radiosurgery is an effective and safe minimally invasive option for patients with brain metastases. Randomized trials include tumors of different histologies which can detract from their relevance to specific tumor types.