Organizational Guideline for the Delivery of Stereotactic Radiosurgery for Brain Metastasis in Ontario

Guideline Objective

To provide the optimal organizational guidelines for facilities performing stereotactic radiosurgery (SRS) on patients with brain metastasis in Ontario.

Patient Population

Adult patients with brain metastasis eligible for SRS at centres in Ontario.

Intended Guideline Users

1. Clinicians involved in the organization and delivery of care for patients with brain metastases who are eligible to receive SRS in Ontario.
2. Administrators involved in the organization and delivery of care for patients with brain metastases who are eligible to receive SRS in Ontario.

Research Questions

1. Who are the medical professionals who ideally should be part of the MCC evaluating patient eligibility and performing SRS?
2. What are the training and/or certification requirements for members of the MCC performing SRS?
3. What are the minimum applicable technologies required for the safe performance of SRS?
4. What imaging is needed both pre (i.e., simulation) and post (i.e., follow-up) SRS to ensure safe practice and patient safety?
5. What is the appropriate level of QA for: (a) treatment-delivery unit/machine quality control; (b) imaging; and (c) treatment planning
6. What are the minimum requirements for patient follow-up after the SRS procedure (i.e., MRI timing and frequency)?