Abstract
BACKGROUND: The risk for radionecrosis is a main problem in the radiotherapy oncology specially for Re-Radiation in the brain for brain tumors recurrence or brain metastasis progression. The whole brain radiotherapy is indicated by multiple brain metastasis more than 3 lesions. By the oligometastatic disease with brain metastasis (1- 3 lesions) a local radiotherapy such as radiosurgery or stereotactic radiotherapy is indicated. Many patients with multiple brain metastasis from breast cancer are radiated with Whole Brain radiotherapy and with the new target therapies they have a longer survival. By progression in the brain or new brain metastasis a local radiotherapy is indicated. With the advances in radiotherapy oncology with the new radiotherapy techniques a Re-radiation is possible with high dose and a good safety for the risk organs in order to avoid the radionecrosis risk. CONCLUSION: The VMAT-technique (volumetric modulated arc therapy) for Re-radiation in the brain for progressive brain metastasis after previous radiation specially whole brain radiotherapy is indicated due to the good safety for the Organ at Risk in order to avoid radionecrosis risk.