Radiosurgery and re-irradiation of brain metastases with cyberknife

Lung cancer is a leading cause of cancer incidence and mortality worldwide with more than 2 million newly diagnosed cases in 2018. The disease is usually diagnosed in stage 3 or 4 with extensive clinical symptoms, which is a bad prognostic factor. Around 40% of patients with brain metastases are with a primary lung cancer, which shows the importance of this pathology. The main treatment option for inoperable lesions is radiosurgery, which can be done more than once in case of progression. This gives an opportunity to deliver a high dose in low volume with a high dose gradient while maintaining healthy tissues. Re-irradiation gives a change for good quality of life for patients with a long life expectancy. This case confirms that two and even three times re-irradiation with CyberKnife is an effective and safe therapeutic option for patients with brain metastases.