title: [Multiple brain metastases after breast cancer and their radiotherapy management: what is the optimal treatment?].
abstract: Whole brain radiotherapy remains standard in the management of breast cancer patients with brain metastases. It allows for symptomatic improvement and good local control in most patients. However, its results remain suboptimal in terms of both efficacy and toxicity. In highly selected patients, stereotactic radiotherapy demonstrated very good local control with low toxicity. With purpose of improving the efficacy/toxicity ratio, strategies of biomodulation of tumor radiosensitivity were recently developed. First results are promising and warrant further assessment. At the same time, new technologies and new irradiation modalities demonstrated their ability in providing high dosimetric homogeneity, delivering integrated radiation boosts, and avoiding critical structures that are involved in long-term neurological toxicity. Further assessment is required and recruitment of breast cancer patients into clinical trials is encouraged.
authors.affiliation: Institut Curie, département d'oncologie radiothérapie, 26, rue d'Ulm, 75005 Paris, France. youlia.kirova@curie.net
authors.forename: Youlia M
authors.initials: YM
authors.lastname: Kirova
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Mazeron
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy*; D001943:Breast Neoplasms; D003131:Combined Modality Therapy / Q000379:methods; D016371:Cranial Irradiation / Q000379:methods*; D005260:Female; D006801:Humans; D016634:Radiosurgery / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods
chemical_list: D000970:Antineoplastic Agents