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Cancer metastatic to brain prognosis instance, hair loss, which is one of the major concerns for some patients, such as a young lady with BM of breast cancer, is a less frequently encountered problem with SRS than WBRT as a result of the smaller irradiated field size and focalized dose distribution Figure 2. All the aforementioned advantages of SRS are provided by utilization of multiple convergent narrow beams to deliver high dose focal irradiation in a single fraction by using multiple cobalt sources, linear accelerators or cyclotrons 37, Similar with neurosurgery, SRS alone or in combination with WBRT has been exhibited to associate with prolonged overall survival, local control and also better neurologic status in these patients compared to WBRT alone 33,
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The patient initially received palliative chemotherapy with Paclitaxel, discontinued due to allergic reactions, and targeted therapy with Herceptin. BM were treated with antalgic radiotherapy and bisphosphonates. After the occurrence of secondary brain lesions, the patient underwent palliative whole-brain radiotherapy WBRT and systemic treatment with Capecitabine and Lapatinib from February
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