{"id":"4b91062c-16a7-450c-a08d-ec206925250d","slug":"commentary-on-effect-of-radiosurgery-alone-vs-radiosurgery-with-whole-brain-radiation-therapy-on-cognitive-function-in-patients-with-1-3-brain-metastases-by-brown-et-al-jama-2016316401-9","title":"Commentary on effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1-3 brain metastases by Brown <i>et al</i>. JAMA 2016;316:401-9","authors":["L. Dade Lunsford"],"abstract":"Background: The commentary discusses the implications of a prospective randomized trial by Brown et al. that evaluated cognitive function and tumor control in patients with 1–3 brain metastases. It highlights the shift in management strategies from whole brain radiation therapy (WBRT) to stereotactic radiosurgery (SRS) due to the latter's reduced cognitive decline in patients. Summary: The commentary emphasizes the evolving landscape of brain metastasis treatment, noting the historical reliance on WBRT and the recent adoption of SRS as a primary management option. It critiques the existing biases in training and practice among radiation oncologists and neurosurgeons, advocating for a more nuanced understanding of patient factors beyond the number of metastases. Conclusion: The author argues for the continued use of SRS over WBRT due to its effectiveness and lower toxicity, while acknowledging the need for ongoing research into the role of targeted therapies for brain metastases. The commentary concludes that SRS should be the preferred treatment option for patients with brain metastases. Keywords: radiosurgery, whole brain radiation therapy, cognitive function, brain metastases, treatment strategies, neurosurgery, oncology","thumbnailUrl":null,"publishDate":"2016-10-19T00:00:00.000Z","doi":"10.4103/2152-7806.192634","categories":["Commentary"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2016/11/8026/SNI-7-90.pdf"}