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Patrick Maguire, MD, Oncology, answeredCommon acute side effects of whole-brain radiation therapy (RT) include hair loss, scalp irritation, and moderate fatigue. The most common long-term side effect is difficulty with short-term memory or complex thinking. In rare cases, patients may develop significant difficulty with their thought processes. Focal, severe brain necrosis from whole-brain RT occurs very rarely since the dose is low to moderate.