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Table 1 Eligibility Criteria

From: Randomised prospective phase II trial in multiple brain metastases comparing outcomes between hippocampal avoidance whole brain radiotherapy with or without simultaneous integrated boost: HA-SIB-WBRT study protocol

Inclusion Criteria Exclusion Criteria
• 21–80 years old patients
• Radiological confirmed brain metastases (4–25 lesions)
• Histologically proven malignancy
• ECOG performance status ≤2
• Maximum lesion or cavity size ≤5 cm
 o For patients with large (≥3 cm) lesions, a neurosurgical consult is recommended due to the increased risk of cerebral oedema
 o If brain surgery or other invasive procedures are performed, the treatment should begin at least 2-weeks post-procedure
• Life expectancy of at least 6 months
• Negative serum pregnancy test within 14 days prior to registration for women of childbearing potential
• Women of childbearing potential and male participants who are sexually active must agree to use a medically effective means of birth control throughout protocol treatment
• Not suitable for or does not want SRS
• Agrees to be randomised to either HA-WBRT or HA-SIB-WBRT
• Prior whole brain radiotherapy.
o Prior SRS is not an exclusion. Details of treatment must be recorded.
• Diffuse leptomeningeal disease
• Extensive extracranial disease, not controlled by systemic treatment
• Major medical or psychiatric illness, which in the investigator’s opinion would interfere with the completion of therapy and follow up
• Dementia, ongoing psychotic episodes or moderate-severe depression (PHQ-9).
• Recent stroke in the past 3 months
• Symptomatic brain metastases limiting ADLs
• Rapid progression of brain lesion
• Patients unable to give informed consent
• Total tumour planning target volume (PTV) > 60 cc
• Radiological evidence of hydrocephalus
• Contraindication to Gadolinium contrast-enhanced MRI brain
• Patients with diagnoses of small cell carcinoma, lymphoma or primary brain tumour