Introduction: The role of stereotactic radiosurgery is increasing in the management
of brain and spine metastases. We review the data supporting its use.
Methods: We used data to compile recommendations for indications, prescription dose
and dose constraints, treatment outcomes, and toxicities.
Results: Stereotactic radiosurgery is demonstrated to be effective and safe in the management
of brain and spine metastases, both upfront and for recurrence. Toxicities, particularly
radiation necrosis and myelopathy, can be morbid and need to be followed for.
Conclusion: While the data support its use, there needs to be continued research with
improved technology, on the use of radiosurgery for larger brain metastases, and on the
toxicities of radiosurgery and its management.