Researchers at UCLA conducted an emailed survey of radiation oncologists last year to identify how stereotactic radiosurgery (SRS) was being utilized to treat brain metastases. Published guidelines note optimal use when patients have no more than 3 brain lesions.
A total of 711 radiation oncologists who indicated they are currently practicing responded to the survey (response rate 12.5%), and the findings were published online ahead of print in the journal Cancer.
Specialists in central nervous system (CNS) tumors were more likely to treat higher numbers of patients with brain metastases with SRS. There was a significant difference in the optimal cutoff number used when deciding how many lesions to treat with SRS versus whole-brain radiotherapy.
Cutoff points were significantly higher for CNS specialists who treated 10 or more patients per month (high-volume) compared with either low-volume CNS specialists (5-9 patients/month) or high-volume, non-CNS specialists (8.1 vs 5.6 and 5.1 respectively). About half of respondents (56%) identified patients with 4-6 brain metastases as being the most challenging patients to treat.
The researchers concluded that consensus is lacking on the optimal treatment strategy for patients with more than 3 brain metastases, and recommend further research in this area. The study findings are available here