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International Journal of Surgical Oncology
Volume 2012, Article ID 952345, 10 pages
Review Article

The Role of Surgery, Radiosurgery and Whole Brain Radiation Therapy in the Management of Patients with Metastatic Brain Tumors

1Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
2Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA

Received 28 May 2011; Accepted 3 October 2011

Academic Editor: Dima Suki

Copyright © 2012 Thomas L. Ellis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Brain tumors constitute the most common intracranial tumor. Management of brain metastases has become increasingly complex as patients with brain metastases are living longer and more treatment options develop. The goal of this paper is to review the role of stereotactic radiosurgery (SRS), whole brain radiation therapy (WBRT), and surgery, in isolation and in combination, in the contemporary treatment of brain metastases. Surgery and SRS both offer management options that may help to optimize therapy in selected patients. WBRT is another option but can lead to late toxicity and suboptimal local control in longer term survivors. Improved prognostic indices will be critical for selecting the best therapies. Further prospective trials are necessary to continue to elucidate factors that will help triage patients to the proper brain-directed therapy for their cancer.