Proton Therapy for Brain Metastases: A Question of Value

Brain metastases from a primary extracranial malignancy are a very common problem in cancer patients, with an estimated 170,000 new cases per year in the US (1). While whole-brain radiation therapy (WBRT) was the mainstay of treatment for patients with multiple brain metastases for many years, concern has grown in recent years over the adverse effects of WBRT on neurocognition and quality of life (2). Consequently, various approaches are being explored to either mitigate the effect of WBRT (eg, memantine, hippocampal-sparing IMRT) or replace this treatment modality entirely (eg, stereotactic radiosurgery, chemotherapy).

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