Brain metastasis from cancer carries a poor prognosis with a median survival of only a few months. However, oncologists at the Windsor Regional Hospital (WRH) have developed a new technology, i.e. hypofractionated stereotactic radiotherapy (HSRT), in the last three years. It is anticipated that this innovative radiation treatment should translate into a better outcome, including higher local control and overall survival and lower toxicities. Oncologists working at WRH have seen this in their practice and have stopped referring patients to larger cancer institutions in London, Hamilton or Toronto for the same HSRT. However, there is a need for a retrospective study to look at data before drawing any conclusion.

This study will investigate the HSRT outcome of brain metastasis in the WRH local cancer program since the development of the HSRT protocol and compared it to conventional whole-brain irradiation (WBI) and craniotomy. We will collect patient data at the WRH cancer program for radiation treatment in recent years, including patient age, gender, diagnosis, cancer stage, treatment received, local control and survival, and toxicities related to radiation. We will compare the outcome of HSRT with those of conventional treatment and surgery. We will also do a literature review to see whether it is time to offer HSRT to all brain metastasis patients to lower the risk of severe neuro-toxicities and keep the same tumour control and survival rate. We hypothesize that the brain metastasis patients treated with HSRT would have better outcomes and overall survival due to lower toxicities than conventional whole-brain irradiation and surgery.

The result of this study will benefit future WRH cancer patients with brain metastasis by shedding new light on the more recent treatments available close to home and guide the treatment of brain metastasis patients in the future.