Radiotherapy for brain metastases: 2025 update

We present the updated recommendations of the Société française de radiothérapie oncologique (the French Society for Radiation Oncology) on the indications and technical modalities of radiotherapy for brain metastases. The management of brain metastases represents a complex therapeutic challenge, due to the increase in patient life expectancy, technological advances in imaging and radiotherapy, specific and relevant prognostic classifications, the increased intracranial efficacy of certain systemic therapies and also the possible iterative irradiation sequences. The prevention of acute and late side effects is essential. Therapeutic strategies defined in a multidisciplinary manner are becoming increasingly personalized and must be rediscussed according to the evolution of the intracranial and extracranial disease.