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The Department of Neurosurgery at the University of Texas M.D. Anderson Cancer Center, from their OncoLog (as well as the UCLA Metastatic Brain Tumor Program and University of Pittsburgh School of Medicine), admits that whole brain radiation may still be a standard for four or more brain mets. However, there are a variety of effective "focal" treatment modalities for people who have fewer than four tumors.
That being said, there maybe some value in having chemotherapy, instead of going the route of whole brain radiation. Temador is one of the targeted drug regimens that has had much success with brain mets, if it is "sensitive" to the cancer cells. Temodar has been shown to benefit those that are benefitting from it.
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