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Spread of cancer to brain called as brain metastases is known to occur in few cancers. All patients with brain metastases require radiation therapy to brain.
Traditional treatment for brain metastases is -whole brain radiation therapy over 1-2 weeks. Whole brain radiation therapy is associated with adverse effects like temporary hair loss, somnolence (tendency to sleep more) and some decline in cognition.
We try to avoid these side effects by using IM- IGRT techniques where we spare some critical areas of brain called hippocampus to avoid cognition decline (called as Hippocampal sparing whole brain RT). In IMRT it’s also possible to spare scalp (skin and hair lining of head) to minimize hair loss.
Good news is that patients with limited /few brain metastases can avoid whole brain RT (and it’s side effects) by focusing radiation therapy only on metastases by a technique called as Stereotactic Radiosurgery (SRS).
In SRS a tight stereotactic mask is made for patient to avoid any movement of head while on treatment. Computerized plan is made using CT scan and MRI together to focus radiation only on metastases. SRS has several advantages like shorter treatment time (2-5 days), minimal hair loss and no decline in cognition.
At Max Hospital, Shalimar Bagh, we are routinely doing SRS and Hippocampal sparing whole brain radiation therapy for suitable patients.