Treatment of brain metastases in uncommon tumors.
Melanoma spreads to the CNS with an incidence of 4 to 20%. Metastases from cancer of the colorectal and genitourinary tract, as well as sarcoma, are less frequent (1%). Surgery should be considered for single brain metastases in patients with controllable disease. Stereotactic needle biopsy may still be worthwhile to confirm diagnosis, and also in patients whose tumors are considered unresectable. Whole-brain radiotherapy is the treatment of choice for most brain metastases, since more than 70% of patients have multiple metastases at the time of diagnosis. Radiosurgery is particularly useful for patients unable to tolerate surgery and for patients with lesions inaccessible to surgery. Chemotherapy could be useful in patients with asymptomatic brain metastases and uncontrolled extracranial disease, depending on performance status and previous chemotherapy received.
Department of Medical Oncology, Azienda Ospedale, University of Padova, Italy. alicia.tosoni@unipd.it
Alicia
A
Tosoni
Franco
F
Lumachi
Alba A
AA
Brandes
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001707:Biopsy, Needle; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003937:Diagnosis, Differential; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology; D005833:Genital Neoplasms, Female / Q000473:pathology; D006304:Health Status; D006801:Humans; D015994:Incidence; D008545:Melanoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D016634:Radiosurgery; D012878:Skin Neoplasms / Q000473:pathology; D014571:Urologic Neoplasms / Q000473:pathology