title: Neurosurgical and radiosurgical decision making in brain metastasis patients in the area of targeted therapies?
abstract: The incidence of brain metastases (BM) is increasing to date, mostly due to the actual improvement of cancer patient overall survival (OS) with the advent of targeted therapies. BM management has dramatically evolved over the last 15 years and uses varying strategies including more or less aggressive local treatments, sometimes combined with systemic therapies that led to an improvement of patient's survival and quality of life. The therapeutic decision is still a matter of debates among experts during multidisciplinary staff, taking into account established prognostic factors including patient's general condition (clinical and functional status of the patient), extra-cerebral disease status, characteristic of intracranial metastases and clinical and radiological presentation of BM. In this article, we reviewed evidence based data available in the literature on the local treatment of BM.
authors.affiliation: Professor of Neurosurgery, Department of Neurosurgery, Clairval Hospital Center, 317, Boulevard du Redon, 13009 Marseille, France. philippe.metellus@outlook.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Metellus
authors.affiliation: Department of Neurosurgery, Clairval Hospital Center, Generale de Sante, Marseille 13009, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bialecki
authors.affiliation: Department of Neuro-oncology, Roger Salengro Hospital, University Hospital, 59037 Lille, France; Department of Medical Oncology, Oscar Lambret Center, 59020 Lille, France; Laboratoire PRISM, INSERM U-1192, Lille 1 University, 59655 Villeneuve D'Ascq, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Le Rhun
authors.affiliation: Department of Radiotherapy, Gustave Roussy University Hospital, Villejuif 94800, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Dhermain
mesh_terms: D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D003661:Decision Support Techniques; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000401:mortality; D018579:Patient Selection; D011237:Predictive Value of Tests; D016634:Radiosurgery / Q000009:adverse effects / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Brain metastases (BM); radiosurgery; stereotactic radiotherapy (SRT); surgery; tumor biology