Brain metastases

Spencer, Katie; Hall, Allison; Jain, Pooja

doi:10.7861/clinmedicine.14-5-535

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…Cancer cells can often be found in cerebrospinal fluid smear examination of such patients. Among various metastases in the whole body, brain metastases rank third, only second to liver and lung metastases [1]. With the development of multidisciplinary treatment, imaging technology, and the prolongation of patient survival, in recent years, the incidence of brain metastases of malignant tumors has increased significantly.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Cranial Nerve Injury after Radiotherapy for Large Brain Metastases

Zhou

Zhang

Chen

et al. 2021

Journal of Healthcare Engineering

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Section: Introductionmentioning

confidence: 99%

Factors Associated with Cranial Nerve Injury after Radiotherapy for Large Brain Metastases

Zhou

Zhang

Chen

et al. 2021

Journal of Healthcare Engineering

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“…Brain metastases are a significant cause of morbidity and mortality with an incidence of up to 40% during the trajectory of several cancer types . New treatment options have led to improved overall survival (OS) in selected patient groups; however, the median OS of 3–6 months remains disappointing .…”

Section: Introductionmentioning

confidence: 99%

Local control and possibility of tailored salvage after hypofractionated stereotactic radiotherapy of the cavity after brain metastases resection

et al. 2018

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In patients undergoing surgical resection of brain metastases, the risk of local recurrence remains high. Adjuvant whole brain radiation therapy (WBRT) can reduce the risk of local relapse but fails to improve overall survival. At two tertiary care centers in Germany, a retrospective study was performed to evaluate the role of hypofractionated stereotactic radiotherapy (HFSRT) in patients with brain metastases after surgical resection. In particular, need for salvage treatment, for example, WBRT, surgery, or stereotactic radiosurgery (SRS), was evaluated. Both intracranial local (LF) and locoregional (LRF) failures were analyzed. A total of 181 patients were treated with HFSRT of the surgical cavity. In addition to the assessment of local control and distant intracranial control, we analyzed treatment modalities for tumor recurrence including surgical strategies and reirradiation. Imaging follow‐up for the evaluation of LF and LRF was available in 159 of 181 (88%) patients. A total of 100 of 159 (63%) patients showed intracranial progression after HFSRT. A total of 81 of 100 (81%) patients received salvage therapy. Fourteen of 81 patients underwent repeat surgery, and 78 of 81 patients received radiotherapy as a salvage treatment (53% WBRT). Patients with single or few metastases distant from the initial site or with WBRT in the past were retreated by HFSRT (14%) or SRS, 33%. Some patients developed up to four metachronous recurrences, which could be salvaged successfully. Eight (4%) patients experienced radionecrosis. No other severe side effects (CTCAE≥3) were observed. Postoperative HFSRT to the resection cavity resulted in a crude rate for local control of 80.5%. Salvage therapy for intracranial progression was commonly needed, typically at distant sites. Salvage therapy was performed with WBRT, SRS, and surgery or repeated HFSRT of the resection cavity depending on the tumor spread and underlying histology. Prospective studies are warranted to clarify whether or not the sequence of these therapies is important in terms of quality of life, risk of radiation necrosis, and likelihood of neurological cause of death.

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“…With solitary tumors, the goal is resection with possible cure, whereas with multiple metastases, the goal is often palliative. Regardless of the goal, treatment must be carefully planned to avoid unnecessary treatment burden and toxicity in the last few weeks of life (Spencer, Hall, & Jain, 2014).…”

Section: Treatmentmentioning

confidence: 99%

“…Unless a contraindication exists, symptomatic patients with BMs are empirically treated with corticosteroids (Klos & O'Neill, 2004). High-dose dexamethasone provides symptomatic relief by reducing cerebral edema; typical regimens require 16 mg per day for 48 hours that is tapered to a maintenance dose of 2-4 mg per day (Spencer et al, 2014).…”

Section: Supportive Carementioning

confidence: 99%

Current Perspectives in the Management of Brain Metastases

Saria

Piccioni

Orosco

et al. 2015

CJON

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Brain metastases (BMs) are diagnosed in 10%-40% of all patients with cancer, and the incidence continues to increase along with the number of long-term survivors. When BMs occur, they are often associated with a myriad of symptoms, including neurologic dysfunction and functional decline; both are difficult to manage and can be distressing for patients and their caregivers. Although clinically significant findings have not kept up with the rapid pace of scientific breakthroughs in understanding the mechanisms of BMs, novel approaches that affect the prognosis of patients with BMs have been introduced in clinical practice. At a Glance • Screening for brain metastases (BMs) is not routinely performed in patients with no neurologic symptoms. However, screening is indicated in lung cancer and possibly in the context of high-risk cancers. • Individual differences in patients warrant a personalized approach in the management of BMs. • Whole brain radiation therapy and steroids are considered to be the cornerstones of treatment for BMs.

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Brain metastases

Cited by 7 publications

References 12 publications

Factors Associated with Cranial Nerve Injury after Radiotherapy for Large Brain Metastases

Factors Associated with Cranial Nerve Injury after Radiotherapy for Large Brain Metastases

Local control and possibility of tailored salvage after hypofractionated stereotactic radiotherapy of the cavity after brain metastases resection

Current Perspectives in the Management of Brain Metastases

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