Treating brain metastases: current approaches and future directions.
Brain metastases frequently present with neurologic signs or symptoms in a patient with a history of cancer. The finding of a brain metastasis is usually associated with terminal disease. However, patients with brain metastases are a heterogeneous group. Therefore, the treatment of brain metastases must be tailored to each individual patient. In this article, which patients with brain metastases benefit from surgical resection, radiosurgery and whole-brain radiation therapy are reviewed. Reports of treating patients with brain metastases with chemotherapy are also reviewed and data that supports prophylactic treatment of the brain for select patients is discussed. This review aims to provide a framework for treating patients with different presentations of brain metastases and to highlight important avenues for future research.
Kirsch
David G
DG
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, 100 Blossom Street, Boston, MA 02114, USA. dkirsch@partners.org
Loeffler
Jay S
JS
D001932:Brain Neoplasms / Q000453:epidemiology / Q000556:secondary* / Q000628:therapy*; D002986:Clinical Trials as Topic; D004358:Drug Therapy / Q000379:methods; D006801:Humans; D009362:Neoplasm Metastasis / Q000628:therapy*; D016634:Radiosurgery / Q000379:methods; D013997:Time Factors