- Brain metastases should be treated with local therapy (stereotactic radiotherapy or whole brain radiotherapy), and patients should be asymptomatic, without treatment with steroids for four weeks before enrollment. Before enrollment, new brain imaging (contrast-CT or gadolinium-MRI) is needed to demonstrate that there is no progression in the brain when the last brain imaging is more than four weeks earlier. Screening for brain metastases is not necessary in patients that were previously not diagnosed with brain metastases and that are without signs indicative of brain metastases.