Genu-Sparing Whole-Brain Radiotherapy in Preserving Cognition and Neuropsychiatric Functioning in Patients with Solid Tumors with Brain Metastases

Inclusion Criteria

• Histologic proof or unequivocal cytologic proof of solid tumor malignancy; this may be obtained from either the primary or any metastatic site
• Mini-mental status exam (MMSE) >= 24 OR Montreal Cognitive Assessment Functional Test (MoCA) Blind >= 18.
• Karnofsky performance status >= 70
• Patient must be scheduled to undergo treatment with WBRT to manage the brain metastases
• Patient does not have any brain metastases in the genu
• Patients of childbearing potential (male or female) must practice adequate contraception
• Patient must have the ability to understand and the willingness to sign a written informed consent document
• All patients must be informed of the investigational nature of this study and must be given written informed consent in accordance with institutional and federal guidelines
• Patient must have a minimal life expectancy of at least 6 months
• Patients receiving prior stereotactic radiosurgery (SRS) for brain metastases are eligible

Exclusion Criteria

• Prior WBRT
• MMSE < 24 or MoCA Blind < 18.
• Patients with brain metastases in the genu
• Patients must not have a serious medical or psychiatric illness that would, in the opinion of the treating physician prevent informed consent or completion of protocol treatment, and/or follow-up visits
• Karnofsky performance status (KPS) < 70
• Non-native English speakers will be excluded since patients often lose their faculty with the language they acquired second before their native language is affected in the context of cognitive decline; this could adversely affect performance on verbal cognitive tasks
• Patients with absolute contraindication to magnetic resonance imaging (MRI) imaging are not eligible for the study