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Post-operative Cavity SRS — SCE Medical Oncology MCQ

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ModerateCNS TumoursPost-operative Cavity SRSSCE Medical Oncology

A 62-year-old woman undergoes craniotomy for a large brain metastasis from breast cancer. Post-operative MRI shows complete resection. What adjuvant brain treatment is recommended?

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Correct answer: A — Post-operative cavity stereotactic radiosurgery (SRS) to the surgical cavity

After surgical resection of a brain metastasis, post-operative cavity SRS is now the standard of care (replacing post-operative WBRT) based on the NCCTG N107C trial (Brown et al Lancet Oncol 2017). Cavity SRS reduces local recurrence from ~50-60% (surgery alone) to ~10-15% while preserving neurocognitive function compared with WBRT. WBRT significantly increases neurocognitive decline at 3 months (particularly memory). Cavity SRS requires careful treatment planning to conform to the irregular surgical cavity.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer