Takeaway
High local tumor control can be achieved with stereotactic radiosurgery (SRS) independent of the number of metastases treated at once; a high number of metastatic brain tumors should not rule out SRS, and metachronous treatment is not inferior to synchronous treatment.
Why this matters
There are few reports of survival, tumor control achieved, and brain volume exposed to 12 grays (V12Gy) with SRS alone, rather than whole brain radiation therapy (WBRT), to treat ≥10 brain metastases.
This study shows that SRS is highly precise, with relative sparing of nearby tissue and decreased neurocognitive morbidity compared with WBRT.