• Jonathan H Sherman, Simon S Lo, Tom Harrod, Alia Hdeib, Yiping Li, Timothy Ryken, and Jeffrey J Olson.
• Department of Neurosurgery, The George Washington University, School of Medicine and Health Sciences, Washington, District of Columbia.
• Neurosurgery. 2019 Mar 1; 84 (3): E175-E177.

Question 1Should patients with brain metastases receive chemotherapy in addition to whole brain radiotherapy (WBRT) for the treatment of their brain metastases?Target PopulationThis recommendation applies to adult patients with newly diagnosed brain metastases amenable to both chemotherapy and radiation treatment.RecommendationsLevel 1: Routine use of chemotherapy following WBRT for brain metastases is not recommended. Level 3: Routine use of WBRT plus temozolomide is recommended as a treatment for patients with triple negative breast cancer.Question 2Should patients with brain metastases receive chemotherapy in addition to stereotactic radiosurgery (SRS) for the treatment of their brain metastases?RecommendationsLevel 1: Routine use of chemotherapy following SRS is not recommended. Level 2: SRS is recommended in combination with chemotherapy to improve overall survival and progression free survival in lung adenocarcinoma patients.Question 3Should patients with brain metastases receive chemotherapy alone?RecommendationLevel 1: Routine use of cytotoxic chemotherapy alone for brain metastases is not recommended as it has not been shown to increase overall survival.Please see the full-text version of this guideline (https://www.cns.org/guidelines/guidelines-treatment-adults-metastatic-brain-tumors/chapter_5) for the target population of each recommendation.Copyright © 2019 by the Congress of Neurological Surgeons.

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