Management of Cerebral Brain Metastasis

Abstract

Brain metastasis is associated with a poor overall prognosis, but combination therapies have emerged that may prevent recurrence or serve as palliative therapies. There is a wide range of treatment options for those with 1-3 intracranial metastases and stable disease, including combinations of surgery, whole brain radiation therapy (WBRT), and stereotactic radiosurgery (SRS). Those with few, small metastases may be served well by SRS and adjuvant WBRT, whereas those with larger metastases that are amenable to resection may be treated with surgical excision and adjuvant WBRT. Whole brain radiation alone is reserved for individuals with greater than three brain metastases or unstable disease. A number of studies have been conducted to clarify the optimal treatment regimen for patients with varying intracranial disease. This review aims to synthesize the most current findings pertaining to the neurosurgical treatment of brain metastases.