Stereotactic Radiation vs Hippocampal-Avoidance Whole Brain Radiation

To the Editor The recent trial comparing stereotactic radiation with hippocampal-avoidance whole brain radiation in patients with 5 to 20 brain metastases fills a critical evidence gap. While the primary outcome demonstrated symptom benefit favoring stereotactic radiation, the interpretation of secondary end points warrants further discussion to guide clinicians toward a more comprehensive framework for evaluating clinical outcomes.