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1、COMMENTShisvolumeofNeurosurgeryprovidesanexhaustivereviewoftoday,thebasicradiosurgicalapproachislargelyunchanged.InTcontemporarystrategiesfordiagnosingandmanagingbraincontrast,someincrediblyimportantquestionsremaininquestionormetastases.Theauthorshaveablysynthesizedforthereaders
2、hipofunderdispute.Whatistheroleofwholebrainradiotherapy(WBRT)Neurosurgeryalargequantityofpublishedmaterialcomingfromainpatientstreatedwithradiosurgery,aquestionaddressedinverywiderangeofdisparatesources.ThatprogresshasbeenmadeMehtaandKhuntia’sverythoroughreview?Becauserandomized
3、inunderstandingandtreatingbrainmetastasesisclearlyundeni-studiesdemonstratealowerlikelihoodofregionalrecurrenceinable.Nevertheless,itisworthexaminingmorecriticallywhetherthepatientsundergoingWBRT,somephysicians,especiallyradiationpastdecadehastrulybeen“aneraofrapidadvancement”in
4、theoncologists,arguevociferouslythatcombinationtreatmentisindi-diagnosisandtreatmentofmetastaticbraincancer,asboldlypro-catedinmostpatients.However,theseoftenvauntedstudiesneverclaimedbyBremandPanattil.Havetherereallybeen“significantexaminethecommonpracticeofusingonlyradiosurger
5、ytocontrolimprovements”orevenvaluablenewperspectivesaboutthishugevisibletumors,andsubsequentlyrelyingonregularmagneticreso-probleminneuro-oncology?Inthisregard,Iamlessinclinedtonanceimagingsurveillancetopickupearlynewbrainmetastasescelebratethanmanyoftheseauthorsseemtoimply.prio
6、rtoasubsequentroundofSRS.Meanwhile,nearlyalltheByverydefinition,metastaticcancerimpliesasystemicillness,neurosurgicalcommunityfindsitincredulousthatmanywithintheand,byvirtueofsuch,begsforasystemictherapy.However,radiationoncologycommunityviewWBRTtoberelativelyinnoc-Peereboom’sco
7、mprehensivereviewillustratesthateventhemostuoustocognitivefunctionoverthelongerterm.Theunfortunateadvancedofchemotherapyregimensprovide,atmost,onlyminorrealityisthatthereisnoClass1evidencetoproveotherwise.benefitforpatientswithbrainmetastases,andarguablynomoreDespitetheabovelame
8、ntationsaboutthelackofsignificantad-benefitthan