It is worth reassessing the available treatment options. Approaches to brain metastases have evolved rapidly in recent years, and the timing and scope of new technology adoption vary between countries and hospitals. Current options include:
① Precision radiotherapy: For patients with a limited number of lesions, the prevailing approach has shifted away from routine whole-brain radiotherapy toward stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT). Even some patients with multiple lesions (such as 5–10) may be eligible for precise treatment under suitable conditions.
② Targeted therapy: Some small-molecule inhibitors targeting alterations in EGFR, ALK, HER2, BRAF, and other driver genes can penetrate the blood-brain barrier relatively well and act on intracranial lesions.
③ Immunotherapy: This works primarily through systemic immune activation and is often combined with local treatment.
④ Other options: Neurosurgery, intrathecal therapy, and clinical trials.
The key is not simply whether treatment options exist, but whether a comprehensive assessment has been completed before reaching a conclusion.

In most cases, it is not a choice between one or the other. Both the primary tumor and brain metastases should be considered within a unified treatment plan.
① Prioritize treatments that address both sites: When the primary tumor has actionable driver alterations or relevant immune biomarkers, targeted therapy, immunotherapy, and certain chemotherapy regimens may act on both intracranial and extracranial lesions.
② Address the more urgent condition first: If intracranial lesions cause significant symptoms or increased intracranial pressure, intracranial treatment is generally prioritized. If extracranial disease poses a more immediate threat, the patient's overall condition is stabilized first, with intracranial treatment provided concurrently or subsequently.
③ Combine local and systemic approaches: Local treatments target specific lesions, while systemic therapy helps control extracranial disease and potential tumor spread. The sequence and combination of treatments are determined by a multidisciplinary team based on molecular characteristics, the extent of extracranial metastases, and the patient's performance status.

Patients can gain a preliminary understanding of their treatment options before traveling, although specific arrangements depend on individual circumstances.
① Remote preliminary assessment: We recommend submitting recent contrast-enhanced brain MRI or CT scans, pathology and molecular testing reports for the primary tumor, and previous treatment records to our specialist team. This helps you understand potential treatment options before arriving in China. When all necessary records are available, the preliminary remote assessment usually takes 1–3 business days, subject to consultation scheduling.
② Prompt coordination upon arrival: Appointments and examinations can be scheduled in advance once your visit is confirmed. Necessary examinations can usually begin on the day of arrival or the following day. Once all results are available, treatment can proceed promptly, reducing waiting times and unnecessary travel.
③ Travel and patient support: International patients may receive assistance with treatment-related documentation when needed, subject to the applicable requirements and individual circumstances. Multilingual assistance and pickup and drop-off services are also available.
④ Transparent costs: The treatment plan and itemized costs are discussed thoroughly before treatment, with the aim of making expenses as clear and predictable as possible.

The risks depend on the individual situation. Conventional whole-brain radiotherapy can cause long-term effects, including cognitive decline, which is one reason treatment decisions have become more selective.
① Prioritizing precision radiotherapy: Whenever appropriate, stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) is preferred over whole-brain radiotherapy. These techniques precisely focus high radiation doses on the lesions while exposing surrounding healthy brain tissue to relatively lower doses, helping reduce the risk of neurocognitive impairment.
② When whole-brain radiotherapy is necessary: Techniques such as hippocampal avoidance can further reduce radiation exposure to brain regions associated with memory.
③ Individualized assessment: The need for whole-brain radiotherapy and measures to preserve cognitive function must be carefully evaluated by the physician based on lesion number and location, previous treatments, and the patient's overall condition.

The general principle is to fit treatment into everyday life whenever possible, rather than putting life entirely on hold. The actual schedule depends on the treatment method.
① Radiotherapy: The radiation delivery itself is painless for both stereotactic and conventional radiotherapy. Patients remain awake during treatment, and each session generally lasts a few dozen minutes. Most patients can receive treatment on an outpatient basis or during a short hospital stay, and many can resume their usual daily activities immediately afterward.
② Surgery: Hospitalization is required, and recovery time depends on the extent of resection and the degree of edema.
③ Systemic therapy: Targeted therapy, immunotherapy, and chemotherapy are primarily administered orally or intravenously. Many patients can maintain their daily routines between treatments. Side effects such as fatigue, skin rash, and loss of appetite may occur, but appropriate management options are generally available. Immunotherapy may also cause immune-related adverse events, including pneumonitis, hepatitis, and thyroid dysfunction, which require monitoring and prompt management as directed by the physician.
The length of hospitalization, treatment schedule, and ability to work or travel should be discussed with the attending physician based on the treatment plan and follow-up results.

① Medical records: We recommend providing recent contrast-enhanced brain MRI or contrast-enhanced CT scans, pathology and molecular testing reports for the primary tumor, previous treatment records, and discharge summaries. After receiving these documents, our specialist team will conduct a preliminary assessment to help you understand potential treatment options before traveling to China.
② Travel arrangements: If needed, our hospital can assist with providing treatment-related documents. Visa applications and other procedures are subject to individual circumstances and applicable requirements. By sending your round-trip flight or train itinerary to Guangzhou in advance, you can arrange pickup from the airport or high-speed rail station.
③ Language and accommodation support: Multilingual accompaniment is available, including assistance with hospital admission, payments, obtaining prescribed medications, and communication with medical staff. If you need short-term accommodation outside the hospital between treatment sessions, our staff can suggest accommodation options and provide travel guidance.
④ Private medical insurance: If you have private medical insurance issued abroad, we recommend confirming reimbursement requirements with your insurer in advance. Our hospital can assist by providing medical records, itemized cost statements, and other relevant documents.