Neurocognition and quality-of-life in brain metastasis patients who have been irradiated focally or comprehensively

ABSTRACT As patients are living longer with metastatic disease, preservation of quality of life (QoL) becomes an important goal as treatment shifts from curative to palliative intent. Stereotactic radiosurgery (SRS) has emerged as an alternative to whole brain radiation therapy (WBRT) in the treatment of brain metastases. The decision between SRS and WBRT balances the competing risks of neurocognitive side effects, which are higher in patients treated with WBRT, with risks of intracranial recurrence, which are higher in patients treated with SRS alone. Within this review, we summarize the types of neurocognitive and QoL tests used in clinical trials, and the randomized control trials (RCTs) that evaluated the impact of radiation therapy (RT) on neurocognition and QoL.