Patients suffering from malignancies in advanced stages often develop brain metastases, which limit both the life span and the quality of life.
Therapy options for multiple brain metastases may vary and range from stereotactic radiosurgery (SRS), whole-brain radiotherapy (WBRT), chemotherapy, immunotherapy to palliative best supportive care. Especially the efficacy and toxicity of SRS compared to WBRT in patients with extensive brain metastases (\>4) is not yet clear but of incremental relevance in this seriously ill cohort with a limited life span. These health-impaired patients might especially profit from a less toxic treatment that is also time sparing with 1 or few sessions in SRS versus 10 sessions in WBRT. On the other hand, no compromises in efficacy want to be done.
histologically confirmed malignant illness
4-15 suspect intracranial lesions, taking into consideration all available MRI series
age ≥ 18 years of age
For women with childbearing potential, (and men) adequate contraception.
Refusal of the patients to take part in the study
Inability to tolerate irradiation consistent with the protocol
Small-cell lung cancer (SCLC) or lymphoma as primary malignant illness
>15 suspect intracranial lesions, taking into consideration all available MRI series