title: A review of current management of brain metastases.
abstract: BACKGROUND
  The brain metastasis (BM) represents one of the most common and refractory malignancies worldwide with a rising incidence in all countries. It is generally believed that once a BM has developed, this disease cannot be cured and has a poor prognosis. The challenges of managing this tumor include diagnosis and selective treatment options. In addition, patients with BM frequently have greater expectations of the current therapy outcomes, which hope to get long-term survival and good quality of life.
  
  
  METHODS
  This is a review of current clinical practice based on an exhaustive literature search of PubMed, Embase, and Google Scholar. A series of case studies is presented to provide outcomes of the effective management in BMs that have required treatment for the terminal stage of patients with cancer, and makes recommendations for future practice.
  
  
  RESULTS
  Current technical advances have been made in the diagnosis and treatment of BM. After surgery, radiotherapy, or stereotactic radiosurgery, and for some cases additional systemic chemotherapy for the primary cancer, most patients experience meaningful symptom relief, improved quality of life and longer survival time. An evidence-based summary of recommendations has been produced to guide neurosurgeons and oncologists in managing this particular group of patients.
  
  
  CONCLUSIONS
  On the basis of the available data, this treatment approach for well-selected patients is currently not recommended in the treatment of BMs except in experienced medical centers. Clinical judgment is made balancing surgical, radiotherapy, chemotherapy and management principles to advocacy the best therapy outcome.
authors.affiliation: Department of Neurosurgery, Xijing Institute of Clinical Neuroscience, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China. xzhang@fmmu.edu.cn
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Cao
authors.forename: Gang
authors.initials: G
authors.lastname: Cheng
authors.forename: Bolin
authors.initials: B
authors.lastname: Liu
authors.forename: Jinxiang
authors.initials: J
authors.lastname: Cheng
mesh_terms: D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging