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ASCO/ASTRO/SNO Guideline on Treatment of Brain Metastases 

Guideline published: December 2021

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This multisociety guideline addresses the role of surgery, radiation therapy, and systemic therapy in the treatment of patients with brain metastases. For each of these therapies, a set of clinical questions was considered (summarized below). ASTRO is also publishing a complementary guideline focused only on radiation therapy for brain metastases, which expands on these radiation questions.

  • Surgery: Benefits and harms of surgery and of laser interstitial thermal therapy.
  • Systemic therapy: Which systemic therapy options, alone or in combination, have demonstrated clinical benefits.
  • Radiation therapy: Benefits and harms of whole brain radiation therapy (WBRT); Approaches to mitigate the harms of WBRT; Benefits and harms of: stereotactic radiosurgery (SRS); SRS compared to WBRT; and use of radiation sensitizers?

Developed in collaboration with and endorsed by:

  • American Society of Clinical Oncology
  • American Society for Radiation Oncology
  • Society for Neuro-Oncology


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