Secondary analysis of phase III N107C/CEC.3 trial was conducted to compare whole-brain radiotherapy [WBRT] or stereotactic radiosurgery [SRS]) regarding quality of life (QOL) and cognition outcomes for patients with limited brain metastasis following surgical resection. In this randomized trial which included 48 institutions in the US and Canada, Adult patients with 1-3 resected brain metastasis and a resection cavity less than 5·0 cm were randomly assigned (1:1) to either postoperative SRS or WBRT.

After median follow-up of 23.8 months, secondary analysis was in accordance with the primary. Cognitive deterioration was less frequent with SRS (37%-60%) compared with WBRT (75%-91%) at all time points. Overall QOL and functional independence favoured SRS alone at all time points. However, intracranial tumor control was improved with WBRT. Total intracranial control for SRS alone vs WBRT at 12 months was 40.7% vs 81.5%, respectively.