Treatment of brain metastases Review uri icon

Overview

MeSH Major

  • Brain Neoplasms

abstract

  • Brain metastases (BMs) occur in 10% to 20% of adult patients with cancer, and with increased surveillance and improved systemic control, the incidence is likely to grow. Despite multimodal treatment, prognosis remains poor. Current evidence supports use of whole-brain radiation therapy when patients present with multiple BMs. However, its associated cognitive impairment is a major deterrent in patients likely to live longer than 6 months. In patients with oligometastases (one to three metastases) and even some with multiple lesions less than 3 to 4 cm, especially if the primary tumor is considered radiotherapy resistant, stereotactic radiosurgery is recommended; if the BMs are greater than 4 cm, surgical resection with or without postoperative whole-brain radiation therapy should be considered. There is increasing evidence that systemic therapy, including targeted therapy and immunotherapy, is effective against BM and may be an early choice, especially in patients with sensitive primary tumors. In patients with progressive systemic disease, limited treatment options, and poor performance status, best supportive care may be appropriate. Regardless of treatment goals, use of corticosteroids or antiepileptic medications is helpful in symptomatic patients. In this review, we provide a summary of current therapy, as well as developments in the treatment of BM from solid tumors.

publication date

  • October 20, 2015

Research

keywords

  • Review

Identity

Language

  • eng

PubMed Central ID

  • PMC5087313

Digital Object Identifier (DOI)

  • 10.1200/JCO.2015.60.9503

PubMed ID

  • 26282648

Additional Document Info

start page

  • 3475

end page

  • 84

volume

  • 33

number

  • 30