Dr. Amara Nwosu Added a discussion

Added a discussion to , Intracranial Metastasis

Hippocampal sparing with 12+ metastases: is it still worth it?

For patients with more than twelve small metastases, do you still go for SRS with hippocampal sparing or move to whole brain? Interested in how you decide and what you tell patients.

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· Dr. Marcus Okafor

· 2026-10-11T22:48:06+0000
We treat up to about 15 lesions with SRS if the total volume is low and the patient is fit. Above that, cumulative volume matters more to us than the count.
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· Dr. Yuna Park

· 2026-10-12T00:48:06+0000
Same here. We also look at the speed of new lesions between scans; rapid progression pushes us towards a different approach.
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· Tomás Ferreira

· 2026-10-12T02:48:06+0000
From the planning side: single-isocentre plans handle 15 lesions well. Happy to share our template in the Brain Metastases Board.

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Dr. Amara Nwosu

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