MR-Linac Guided Adaptive FSRT for Brain Metastases From Non-small Cell Lung Cancer

Exclusion Criteria

• •Small cell carcinoma of lung
• •Intracranial metastases needed surgical decompression
• •Patients with contraindications for MRI
• •Previous radiotherapy or excision for intracranial metastases
• •The tumor has completely approached, encircled, or invaded the intravascular space of the great vessels (e.g., the pulmonary artery or the superior vena cava)
• •A cavity over 2cm in diameter of primary tumor or metastasis
• •Bleeding tendency or coagulation disorder
• •Hemoptysis (1/2 teaspoon blood/day) happened within 1 month
• •The use of full-dose anticoagulation within the past 1 month
• •Severe vascular disease occurred within 6 months
• •Gastrointestinal fistula, perforation or abdominal abscess occurred within 6 months
• •Hypertensive crisis, hypertensive encephalopathy, symptomatic heart failure (New York class II or above), active cerebrovascular disease or cardiovascular disease occurred within 6 months
• •Uncontrolled hypertension (systolic \> 150mmHg and/or diastolic \> 100mmHg)
• •Major surgery within 28 days or minor surgery or needle biopsy within 48 hours
• •Urine protein 3-4+, or 24h urine protein quantitative \>1g
• •Severe uncontrolled disease
• •Uncontrollable seizure or psychotic patients without self-control ability
• •Women in pregnancy, lactation period
• •Other not suitable conditions determined by the investigators