When a patient receives radiation to the entire brain it is called FWBRT, or fractionated whole brain radiotherapy. Usually completed within 10-14 days, this is the conventional radiation most patients with brain metastasis used to receive.
In some patients, FWBRT may unfortunately lead to cognitive deficit. Now that cancer patients have a much better long-term prognosis with the advent of newer treatment modalities, we do not recommend this form of treatment as our first approach. At MBTC, we have limited its use for patients with diffuse multiple brain tumors or those with leptomeningeal disease. Leptomeningeal means the cancer cells have spread along the cerebrospinal fluid or the brain lining, called the meninges. This form of treatment does not involve the neurosurgeon, but your radiation oncologist will discuss the treatment details.
Patients undergoing FWBRT are still advised to call Dr. Sahni’s office for a follow-up scan and visit in two months. Patients who respond well to FWBRT may develop new tumors after the treatment and they can still be treated with Gamma Knife depending on their clinical condition. Regardless of the mode of treatment, we strongly encourage a close follow-up with both your oncologist and your neurosurgeon.