Whole-brain radiation therapy (WBRT) has commonly been prescribed to palliate symptoms from brain metastases, to reduce the risk of local relapse after surgical resection, and to improve distant brain control after resection or radiosurgery. While targeting micrometastases throughout the brain can be considered advantageous, the simultaneous exposure of healthy brain tissue might cause adverse events. Attempts to mitigate the risk of neurocognitive decline after WBRT include the selective avoidance of the hippocampi, among others. Besides selective dose reduction, dose escalation to boost volumes, for example, simultaneous integrated boost, aiming at increased tumor control probability is technically feasible. While up-front radiotherapy for newly diagnosed brain metastases often employs radiosurgery or other techniques targeting visible lesions only, sequential (delayed) salvage treatment with WBRT might still become necessary. In addition, the presence of leptomeningeal tumors or very widespread parenchymatous brain metastases might prompt clinicians to prescribe early WBRT.

全脑放射治疗 (WBRT) 通常用于缓解脑转移的症状，降低手术切除后局部复发的风险，并改善切除或放射手术后的远处大脑控制。虽然靶向整个大脑的微转移被认为是有利的，但健康脑组织的同时暴露可能会导致不良事件。减轻 WBRT 后神经认知能力下降风险的尝试包括选择性回避海马体等。除了选择性减量, 剂量递增以增加体积，例如，同时综合增加，旨在增加肿瘤控制概率在技术上是可行的。虽然针对新诊断的脑转移瘤的前期放疗通常采用放射外科手术或其他仅针对可见病变的技术，但使用 WBRT 进行序贯（延迟）补救治疗可能仍然是必要的。此外，软脑膜肿瘤或非常广泛的脑实质转移瘤的存在可能促使临床医生开具早期 WBRT。