Treatment of brain metastases Journal Article

Authors: Lin, X.; Deangelis, L. M.
Article Title: Treatment of brain metastases
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. Copyright © 2015 American Society of Clinical Oncology. All rights reserved.
Keywords: cancer chemotherapy; cancer surgery; primary tumor; review; solid tumor; cancer radiotherapy; brain radiation; anticoagulant therapy; patient care; immunotherapy; brain metastasis; stereotactic radiosurgery; anticonvulsive agent; corticosteroid; anticoagulant agent; randomized controlled trial (topic); human; priority journal
Journal Title: Journal of Clinical Oncology
Volume: 33
Issue: 30
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2015-10-20
Start Page: 3475
End Page: 3484
Language: English
DOI: 10.1200/jco.2015.60.9503
PROVIDER: scopus
PUBMED: 26282648
PMCID: PMC5087313
Notes: Export Date: 2 December 2015 -- Source: Scopus
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  1. Xuling   Lin
    9 Lin
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