Chapters Transcript Video Stereotactic Radiation Presented by Ayal Aizer, MD. Dr. Ayal Aizer of Dana-Farber Brigham Cancer Center presents results at #ASCO25 from a phase 3 trial on stereotactic radiation. I'm Ayal Azer. I'm one of the radiation oncologists at Brigham and Women's Hospital and Dana-Farber Cancer Institute, and I focus on brain metastases. So we conducted a trial comparing stereotactic radiation, which means targeting individual metastases as opposed to treating the entire brain with radiation in patients with 5 through 20 brain metastases. Prior studies have told us that In patients with up to 4 brain metastases, that targeted radiation, or SRS is better than whole brain radiation. But there haven't been randomized studies looking at this question beyond forebrain metastasis. So we conducted this trial. It started in 2017, completed accrual in 2024. There were 196 patients on it. And what we found is that stereotactic radiation um was better in many domains, including the primary endpoint um than whole brain radiation. And specifically, patients who got stereotactic radiation had lower cancer related symptom burden and less interference of those symptoms with their daily function than patients who got whole brain radiation, and that met the primary endpoint of the study. We also examined things like activities of daily living and performance status, which assess how functional patients are and how much they can do day to day. And both of those domains also favored stereotactic radiation. And lastly, when we looked at neurocognitive function, and we did this with a whole battery of tests, I would summarize them by saying that there was no test where whole brain radiation performed better, but for most tests at one time point, be it 4 months after treatment or 12 months after treatment, The stereotactic arm was better. So in conclusion, this study really demonstrates that for most patients with 5 through 20 brain metastases, targeting individual tumors rather than treating the entire brain is better for patients. Published June 11, 2025 Created by Related Presenters Ayal Aizer, MD, MHS Medical Oncology View full profile
