Patient selection: brain metastases
Indications for surgery:
(1) The diagnosis for CNS lesions is uncertain.
(2) There are 1 or 2 metastases, especially if associated with cerebral edema.
(3) There is a dominant metastases in a critical location.
Indications for stereotactic radiosurgery:
(1) Multiple metastases AND radiation resistant.
(2) Local relapse after surgical resection of a single brain metastasis.
(3) Salvage therapy for <= 3 recurrent metastases following whole brain radiation therapy.
(4) Following resection of a large single metastasis, especially if in the posterior fossa.
Requirements:
(1) the patient has given informed consent.
(2) Therapy is not futile (poor performance status, progressive disease).
