title: [Treatment of brain metastases].
abstract: Brain metastases (BC) are the cause of important mortality and morbidity in cancer patients. Corticoids and Whole Brain Radiotherapy (WBRT) remains the standard treatment but, at the long-term, the results are disappointing. In patients with a single metastase, the survival and the Quality of Life (QoL) can be improved by surgery combined with WBRT. Unfortunately, if surgery (S) is impossible because of the number and/or the site of the metastases or any contraindication for surgery, radiosurgery (RS) remains a good alternative choice. RS allows an excellent local control of the lesions and can be applied to several lesions at the same time. There is no advantage in in terms of survival between RS + WBRT and S + WBRT or RS alone. RS can therefore be recommended as a first treatment approach, namely when favourable prognostic factors are present. This approach allows to avoid WBRT and its potential toxicity, namely in long-term survival.
authors.affiliation: Centre de Radiochirurgie par Gamma Knife, Hôpital Erasme, Bruxelles. daniel.devriendt@ulb.ac.be
authors.forename: D
authors.initials: D
authors.lastname: Devriendt
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D002277:Carcinoma / Q000175:diagnosis / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D016371:Cranial Irradiation / Q000379:methods / Q000706:statistics & numerical data; D005910:Glioma / Q000175:diagnosis / Q000556:secondary / Q000628:therapy; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D016634:Radiosurgery / Q000379:methods / Q000706:statistics & numerical data; D011878:Radiotherapy / Q000379:methods / Q000706:statistics & numerical data