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Irradiating the entire brain, typically 30 Gy in 10 sessions, when metastases are too numerous or too widespread (leptomeningeal) for focused radiosurgery. It controls disease but dulls memory, so it is now reserved for those cases, with hippocampal-avoidance planning and memantine to limit the decline.
Once routine for any brain metastasis, WBRT (typically 30 Gy in 10 fractions) is now reserved for numerous or leptomeningeal metastases when SRS is impractical, because randomised trials showed no survival gain over SRS alone and clear neurocognitive harm. Hippocampal-avoidance planning and memantine (NRG CC001) reduce the decline. In small-cell lung cancer, prophylactic cranial irradiation is a related low-dose whole-brain treatment now being replaced by MRI surveillance.
Shares EORTC 08993 (Slotman): prophylactic cranial irradiation in extensive-stage small-cell lung cancer, Takahashi trial: prophylactic cranial irradiation with MRI surveillance in extensive-stage small-cell lung cancer, Brain metastases (intracranial disease), Extensive-stage small-cell lung cancer.
Shares QUARTZ, Brain metastases (secondary brain tumours), Brain metastases (intracranial disease), Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS).
Shares Stereotactic radiosurgery (SRS), Prophylactic cranial irradiation vs MRI surveillance, Brain metastases (intracranial disease), Extensive-stage small-cell lung cancer.
Shares Stereotactic radiosurgery (SRS), Brain metastases (secondary brain tumours), Brain metastases (intracranial disease).
Shares Leptomeningeal disease, Alliance N0574 (NCCTG N0574), Stereotactic radiosurgery (SRS), Brain metastases (secondary brain tumours).
Shares Stereotactic radiosurgery (SRS), Prophylactic cranial irradiation vs MRI surveillance, Brain metastases (intracranial disease), ALK-positive non-small-cell lung cancer.
Shares Stereotactic radiosurgery (SRS), Gamma Knife, Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS).
Shares Alliance N0574 (NCCTG N0574), Brain metastases (secondary brain tumours).