Brain metastases: An update on the multi-disciplinary approach of clinical management

Mitchell, Drew; Kwon, Jae Hyun; Kubica, P; Huff, Wei; O’Regan, Ruth; Dey, Mahua

doi:10.1016/j.neuchi.2021.04.001

Cited by 26 publications

(20 citation statements)

References 283 publications

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“…In general, a greater interest in CD prophylaxis in patients undergoing WBRT would be conceivable, considering: (i) the improved prognosis potentially resulting from an earlier BM diagnosis and from the availability of more effective systemic treatments in several solid tumors [ 162 ]; (ii) the persistent use of WBRT in at least one-quarter of the BM patients [ 163 ]; (iii) the lack of availability in some centers, especially in less-resourced settings, of stereotactic RT or techniques capable of delivering HA-WBRT; (iv) the low cost (<1 dollar/day in most countries) and tolerability of memantine.…”

Section: Resultsmentioning

confidence: 99%

Memantine in the Prevention of Radiation-Induced Brain Damage: A Narrative Review

Scampoli

Cammelli

Galietta

et al. 2022

Cancers

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Preserving cognitive functions is a priority for most patients with brain metastases. Knowing the mechanisms of hyperglutamatergic neurotoxicity and the role of some hippocampal areas in cognitive decline (CD) led to testing both the antiglutamatergic pharmacological prophylaxis and hippocampal-sparing whole-brain radiotherapy (WBRT) techniques. These studies showed a relative reduction in CD four to six months after WBRT. However, the failure to achieve statistical significance in one study that tested memantine alone (RTOG 0614) led to widespread skepticism about this drug in the WBRT setting. Moreover, interest grew in the reasons for the strong patient dropout rates in the first few months after WBRT and for early CD onset. In fact, the latter can only partially be explained by subclinical tumor progression. An emerging interpretation of the (not only) cognitive impairment during and immediately after WBRT is the dysfunction of the limbic and hypothalamic system with its immune and hormonal consequences. This new understanding of WBRT-induced toxicity may represent the basis for further innovative trials. These studies should aim to: (i) evaluate in greater detail the cognitive effects and, more generally, the quality of life impairment during and immediately after WBRT; (ii) study the mechanisms producing these early effects; (iii) test in clinical studies, the modern and advanced WBRT techniques based on both hippocampal-sparing and hypothalamic-pituitary-sparing, currently evaluated only in planning studies; (iv) test new timings of antiglutamatergic drugs administration aimed at preventing not only late toxicity but also acute effects.

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Section: Resultsmentioning

confidence: 99%

Memantine in the Prevention of Radiation-Induced Brain Damage: A Narrative Review

Scampoli

Cammelli

Galietta

et al. 2022

Cancers

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“…Dei initiale symptoma varierer i kvalitet og grad ut frå lokalisasjon, vekstrate og type primaertumor (1,2). Pasientar med hjernemetastasar kan òg vere asymptomatiske.…”

Section: Diagnostikkunclassified

“…Det er anslå at om lag 10 % av kreftpasientar vil utvikle hjernemetastasar i sjukdomsforløpet (1). For hjernemetastasar er det ikkje meldeplikt som for primaertumorar, og ein har difor ikkje gode epidemiologiske tal i Noreg.…”

unclassified

Hjernemetastasar – diagnostikk og behandling

Taule¹,

Schipmann-Miletić²,

Thorsen³

et al. 2022

Tidsskriftet

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Institu for biomedisin Det medisinske fakultet Universitetet i Bergen Forfa arbidrag: idé, utforming, søk, revisjon og godkjenning av manus. Erlend Moen Taule er medisinstudent og forskarlinjestudent tilkny forskingslaboratorium for hjernemetastasar ved forskingsgruppe for translasjonell kreftforsking. Forfa aren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonfliktar. Nevrokirurgisk avdelingHaukeland universitetssjukehus og Universitetet i Münster, Tyskland Forfa arbidrag: utforming, li eratursøk, revisjon av manus.Stephanie Schipmann-Miletic er legespesialist og privatdosent i nevrokirurgi. Forfa aren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonfliktar.Institu for biomedisin Det medisinske fakultet Universitetet i Bergen Forfa arbidrag: revisjon og godkjenning av manus. Frits Thorsen er professor og leiar av forskingslaboratorium for hjernemetastasar ved forskingsgruppe for translasjonell kreftforsking. Han er medlem av Society of Neuro-Oncology og American Association of Cancer Research. Forfa aren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonfliktar.Avdeling for kreftbehandling og medisinsk fysikk Haukeland universitetssjukehus Forfa arbidrag: revisjon og godkjenning av manus. Tor-Christian Aase Johannessen er ph.d. og konstituert overlege. Han er medlem av Norsk hjernesvulstkonsortium (NBTC). Forfa aren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonfliktar.

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“…Brain metastases are the most common malignant tumors found in the central nervous system (1). They are 10 times more common than primary central nervous system (CNS) brain tumors, affecting 20 to 40% of all patients with cancer, and greater than 100,000 new patients each year in the United States (2)(3)(4). With improved therapies, increased screening of neurologically asymptomatic patients, and patients living longer, the incidence of brain metastases continues to increase.…”

Section: Introductionmentioning

confidence: 99%

Improving Brain Metastases Outcomes Through Therapeutic Synergy Between Stereotactic Radiosurgery and Targeted Cancer Therapies

et al. 2022

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Brain metastases are the most common form of brain cancer. Increasing knowledge of primary tumor biology, actionable molecular targets and continued improvements in systemic and radiotherapy regimens have helped improve survival but necessitate multidisciplinary collaboration between neurosurgical, medical and radiation oncologists. In this review, we will discuss the advances of targeted therapies to date and discuss findings of studies investigating the synergy between these therapies and stereotactic radiosurgery for non-small cell lung cancer, breast cancer, melanoma, and renal cell carcinoma brain metastases.

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Brain metastases: An update on the multi-disciplinary approach of clinical management

Cited by 26 publications

References 283 publications

Memantine in the Prevention of Radiation-Induced Brain Damage: A Narrative Review

Memantine in the Prevention of Radiation-Induced Brain Damage: A Narrative Review

Hjernemetastasar – diagnostikk og behandling

Improving Brain Metastases Outcomes Through Therapeutic Synergy Between Stereotactic Radiosurgery and Targeted Cancer Therapies

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