Brain metastases

Curr Treat Options Oncol. 2000 Dec;1(5):447-58. doi: 10.1007/s11864-000-0072-3.

Abstract

Brain metastases are an increasingly common complication in patients with systemic cancer. The optimal treatment for each patient depends on careful evaluation of several factors: the location, size, and number of brain metastases; the patient's age, general condition, and neurologic status; and the extent of systemic cancer to name a few. For patients with a single brain metastasis and limited systemic disease, the standard treatment is surgical resection followed by whole brain radiation therapy. In patients with a small, single metastasis, stereotactic radiosurgery is probably comparable to surgery. Patients with several metastases (up to three) and controlled systemic disease can be treated with whole-brain radiation and stereotactic radiosurgery. Patients with multiple metastases (more than three) are generally treated with whole-brain radiation alone. Radiosurgery is effective in treating patients with a limited number of recurrent brain metastases and stable systemic diseases. Surgery may have a role in patients with a large symptomatic recurrent lesion producing mass effect. Reirradiation and chemotherapy may have a limited role in patients with multiple recurrent metastases.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anticonvulsants / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / therapy*
  • Combined Modality Therapy
  • Cranial Irradiation
  • Humans
  • Neoplasms / pathology
  • Neoplasms / therapy*
  • Prognosis
  • Radiosurgery
  • Survival Rate
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anticonvulsants
  • Antineoplastic Agents