Stereotactic Radiosurgery in the Management of Patients With Brain Metastases of Non-Small Cell Lung Cancer: Indications, Decision Tools and Future Directions.

摘要: Brain metastases (BM) frequently occur in non-small cell lung cancer (NSCLC) patients. Most patients with BM have a limited life expectancy, measured months. Selected may experience very long progression-free survival, for example, targetable driver mutation. Traditionally, whole-brain radiotherapy (WBRT) has been the cornerstone of treatment, but its indication is matter debate. A randomized trial shown that poor prognosis, WBRT does not add quality (QoL) nor survival over best supportive care. In recent decades, stereotactic radiosurgery (SRS) become an attractive non-invasive treatment BM. Only irradiated to ablative dose, sparing healthy brain tissue. Intracranial recurrence rates decrease when administered following SRS or resection improve overall and comes at expense neurocognitive function QoL. The downside compared risk radionecrosis (RN) higher developing new during follow-up. Currently, established maximum four Several promising strategies are currently being investigated further outcome BM: effectivity safety more than BM, combining systemic therapy such as targeted agents immunotherapy, shared decision-making option, individualized isotoxic dose prescription mitigate RN enhance local control probability SRS. This review discusses current indications future directions NSCLC focus on value