Central nervous system: Symptoms and toxicities

Palliative radiotherapy (RT) is frequently recommended for the treatment of cancer progression within the central nervous system (CNS). The most common indications for palliative RT to this region include brain metastases, spinal metastases, spinal cord compression, leptomeningeal carcinomatosis, and palliative intent treatment of primary brain neoplasms in elderly or poor performance status patients. Radiation treatment modalities in this setting generally consist of external beam radiation and stereotactic radiosurgery. Expected treatment toxicity depends on a number of factors, including treatment dose, disease location, dose per fraction, concurrent systemic therapies, and radiation modality.