Back to Search
Start Over
Brain metastases: current management and new developments.
- Source :
-
Current opinion in oncology [Curr Opin Oncol] 2008 Nov; Vol. 20 (6), pp. 676-84. - Publication Year :
- 2008
-
Abstract
- Purpose of Review: To review the state-of-the-art and new developments in the management of patients with brain metastases.<br />Recent Findings: Treatment decisions are based on prognostic factors to maximize neurologic function and survival, while avoiding unnecessary therapies. Whole-brain radiotherapy (WBRT) is the treatment of choice for patients with unfavorable prognostic factors. Stereotactic radiosurgery (SRS) or surgery is indicated for patients with favorable prognostic factors and limited brain disease. In single brain metastasis, the addition of either stereotactic radiosurgery or surgery to WBRT improves survival. The omission of WBRT after surgery or radiosurgery results in a worse local and distant control, though it does not affect survival. The incidence of neurocognitive deficits in long-term survivors after WBRT remains to be defined. New approaches to avoid cognitive deficits following WBRT are being investigated. The role of chemotherapy is limited. Molecularly targeted therapies are increasingly employed. Prophylaxis with WBRT is the standard in small-cell lung cancer.<br />Summary: Many questions need future trials: the usefulness of new radiosensitizers; the role of local treatments after surgery; and the impact of molecularly targeted therapies on subgroups of patients with specific molecular profiles. Quality of life and cognitive functions are recognized as major endpoints in clinical trials.
- Subjects :
- Brain Neoplasms secondary
Carcinoma, Non-Small-Cell Lung pathology
Cognition
Humans
Lung Neoplasms pathology
Medical Oncology methods
Neoplasm Metastasis
Quality of Life
Radiosurgery
Randomized Controlled Trials as Topic
Treatment Outcome
Brain pathology
Brain Neoplasms therapy
Carcinoma, Non-Small-Cell Lung radiotherapy
Lung Neoplasms radiotherapy
Radiotherapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1531-703X
- Volume :
- 20
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Current opinion in oncology
- Publication Type :
- Academic Journal
- Accession number :
- 18841050
- Full Text :
- https://doi.org/10.1097/CCO.0b013e32831186fe