On October 23rd, 2014, we updated our
By continuing to use LinkedIn’s SlideShare service, you agree to the revised terms, so please take a few minutes to review them.
Subacute-(3-10wks)somnolence syndrome or persistance fatigue especially in children
Long term-DeAngelis reported 12 pts developed dementia, ataxia, urinary incontinence leading to severe disability
total dose ranged from 25-39Gy/3-6Gy
WBRT +/-SRS for KPS > 70 and controlled primary or Surgery (if highly symptomatic, or mass effect) + WBRT or WBRT for KPS <70 or uncontrolled primary Primary Therapy for Metastatic Brain Disease Lesion number Diagnostic uncertainty and asymptomatic Observation If grows, surgery or SRS+/-WBRT Surgery 1 <1cm >1cm Convincing Metastasis Single Solitary 2-3 >3 KPS > 70 and controlled primary KPS < 70 or uncontrolled primary Surgery +/- WBRT or SRS (<3cm) +/- WBRT for non-surgical candidate (if >3cm, WBRT only) WBRT (surgery to lesions causing mass effect) WBRT (Surgery if tumor causes mass effect) *Surgery or SRS (<3cm) +/- WBRT or
Maximum tolerated dose for radiosurgery
24 Gy < 2cm
18 Gy 2-3 cm
15 Gy 3-4 cm
Shaw E, et al Int J Radiat Oncol Biol Phys. 2000 May 1;47(2):291-8.