Strategy of surgery and radiation therapy for brain metastases

Cancer patients with brain metastases have poor prognoses and their median survival time is about 1 year. Surgery with whole-brain radiation therapy (WBRT) has been used in the treatment of single brain metastasis measuring 3 cm or more. Stereotactic radiosurgery (SRS) including the use of the Gamma...

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Bibliographic Details
Published in:International journal of clinical oncology 2009-08, Vol.14 (4), p.275-280
Main Authors: Narita, Yoshitaka, Shibui, Soichiro
Format: Article
Language:English
Subjects:
Activities of Daily Living
Anticonvulsants - therapeutic use
Antineoplastic Agents - therapeutic use
Brain cancer
Brain Neoplasms - mortality
Brain Neoplasms - radiotherapy
Brain Neoplasms - secondary
Brain Neoplasms - surgery
Cancer Research
Cancer surgery
Cranial Irradiation - adverse effects
Evidence-Based Medicine
Humans
Japan
Medicine
Medicine & Public Health
Metastasis
Neurosurgical Procedures - adverse effects
Oncology
Patient Care Team
Patient Selection
Quality of Life
Radiation therapy
Radiotherapy, Adjuvant
Review Article
Steroids - therapeutic use
Surgical Oncology
Time Factors
Treatment Outcome
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Summary:Cancer patients with brain metastases have poor prognoses and their median survival time is about 1 year. Surgery with whole-brain radiation therapy (WBRT) has been used in the treatment of single brain metastasis measuring 3 cm or more. Stereotactic radiosurgery (SRS) including the use of the Gamma knife and Cyberknife is widely used for the treatment of small and multiple brain metastases; however, recent clinical studies have revealed that SRS + WBRT is superior to WBRT or SRS alone in terms of survival time and local tumor control rates. Here, surgical indications and the strategy of surgery and radiation therapy are discussed, based on many clinical trials of treatments for brain metastases. To improve the survival rate and quality of life for these cancer patients with brain metastases, it is necessary to choose the most suitable mode of surgery and radiotherapy with the close cooperation of physicians, surgeons, radiologists, and neurosurgeons, based on accumulated evidence.
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-009-0917-0