Brain metastases

Metastatic tumors to the brain are an increasing cause of morbidity and mortality in patients with systemic cancers. Many new therapies used to treat systemic cancers do not penetrate the central nervous system (CNS) and do not protect patients from the development of brain metastases. Surgery, radi...

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Bibliographic Details
Published in:Current treatment options in oncology 2001-12, Vol.2 (6), p.537-547
Main Authors: Ewend, M G, Carey, L A, Morris, D E, Harvey, R D, Hensing, T A
Format: Article
Language:English
Subjects:
Adult
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Brain Neoplasms - diagnosis
Brain Neoplasms - mortality
Brain Neoplasms - secondary
Brain Neoplasms - therapy
Breast Neoplasms - pathology
Carcinoma - diagnosis
Carcinoma - mortality
Carcinoma - secondary
Carcinoma - therapy
Chemotherapy
Chemotherapy, Adjuvant
Combined Modality Therapy
Cranial Irradiation
Craniotomy
Diagnostic Imaging
Disease Progression
Epidemiologic Methods
Female
Humans
Lung Neoplasms - pathology
Male
Medical treatment
Melanoma - diagnosis
Melanoma - mortality
Melanoma - secondary
Melanoma - therapy
Prognosis
Radiosurgery
Radiotherapy, Adjuvant
Survival Analysis
Toxicity
Treatment Outcome
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Description
Summary:Metastatic tumors to the brain are an increasing cause of morbidity and mortality in patients with systemic cancers. Many new therapies used to treat systemic cancers do not penetrate the central nervous system (CNS) and do not protect patients from the development of brain metastases. Surgery, radiosurgery, and radiation therapy are all used to treat brain metastases. It is in our opinion a mistake to use only one or two of these modalities to the exclusion of other(s). The role of systemic chemotherapy is still limited, due to both the issues of drug delivery caused by the blood brain barrier and to the relative resistance of many of these tumors to chemotherapy. Traditionally, brain metastases have been grouped together regardless of the origin of the tumor and have been treated with a single algorithm. As we encounter more patients for whom treatment of the brain metastases is an important determinant of survival, we must tailor our treatment strategies to individual tumor types. Also, we must recognize differences in each tumor's sensitivity to chemotherapy and radiotherapy and differences in their biology.
ISSN:1527-2729
1534-6277
1534-5277
DOI:10.1007/s11864-001-0075-8