The Management of Brain Metastases—Systematic Review of Neurosurgical Aspects

Proescholdt, Martin; Schödel, Petra; Doenitz, Christian; Pukrop, Tobias; Höhne, Julius; Schmidt, Nils Ole; Schebesch, Karl‐Michael

doi:10.3390/cancers13071616

Cited by 29 publications

(31 citation statements)

References 176 publications

(80 reference statements)

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“…Resection of metastatic brain lesions provides immediate amelioration of mass effect and neurological deficits and avoids the requirement of long-term steroid use, which in turn allows the early initiation of ICIs [28][29][30]. Advances in neurosurgical technologies such as neuronavigation, intraoperative ultrasound, fluorescence-guided surgery, and intraoperative neuromonitoring lead to safer surgery and reduce the risk of morbidity and mortality with total resection [2]. WBRT and SRS are effective treatment methods following surgery.…”

Section: Surgerymentioning

confidence: 99%

“…The central nervous system (CNS) is a common clinical site for metastasis of NSCLC, which seriously affects the prognosis and quality of life (QOL) of patients. The incidence of CNS metastasis in patients with NSCLC at initial diagnosis is approximately 10% [2,3], and approximately 30% of patients with NSCLC develop CNS metastasis during the course of their disease [4,5]. NSCLC includes adenocarcinoma, squamous cell carcinoma, and large cell carcinoma, and the risk of CNS metastasis for each subtype is 11%, 6%, and 12%, respectively [3].…”

Section: Introductionmentioning

confidence: 99%

“…CNS metastases in NSCLC include brain metastasis (BM) and leptomeningeal metastasis (LM). BM most often occurs in the cerebral hemispheres, cerebellum, and brainstem [2]. On the other hand, LM refers to the spread of malignant tumor cells through the cerebrospinal fluid (CSF) to the leptomeninges (pia and arachnoid mater), which is a rare event with an incidence of only 3-5% in patients with NSCLC.…”

Section: Introductionmentioning

confidence: 99%

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Research Progress and Challenges in the Treatment of Central Nervous System Metastasis of Non-Small Cell Lung Cancer

Wang

Guo

et al. 2021

Cells

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Non-small cell lung cancer (NSCLC) is one of the most common malignant tumors and has high morbidity and mortality rates. Central nervous system (CNS) metastasis is one of the most frequent complications in patients with NSCLC and seriously affects the quality of life (QOL) and overall survival (OS) of patients, with a median OS of untreated patients of only 1–3 months. There are various treatment methods for NSCLC CNS metastasis, including surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy, which do not meet the requirements of patients in terms of improving OS and QOL. There are still many problems in the treatment of NSCLC CNS metastasis that need to be solved urgently. This review summarizes the research progress in the treatment of NSCLC CNS metastasis to provide a reference for clinical practice.

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Section: Surgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Research Progress and Challenges in the Treatment of Central Nervous System Metastasis of Non-Small Cell Lung Cancer

Wang

Guo

et al. 2021

Cells

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“…Surgical management of brain metastases plays an increasingly prominent role in neurosurgical practice. Brain metastases complicate the clinical course of >20% of cancers, and advances in medical oncology have resulted in a growing number of patients who are considered for neurosurgical care [ 1 , 2 ]. This includes cases with multiple metastases [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues

Ersoy

Mokhtari

Brainman

et al. 2021

Cancers

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We retrospectively studied 73 consecutive patients who underwent surgery 2015–2020 for removal of cerebellar metastases (CM). Median overall survival (medOS) varied widely between patients and compared favorably with the more recent literature (9.2, 25–75% IQR: 3.2–21.7 months vs. 5–8 months). Prognostic factors included clinical (but not radiological) hydrocephalus (medOS 11.3 vs. 5.2 months, p = 0.0374). Of note, a third of the patients with a KPI <70% or multiple metastases survived >12 months. Chemotherapy played a prominent prognostic role (medOS 15.5 vs. 2.3, p < 0.0001) possibly reflecting advances in treating systemic vis-à-vis controlled CNS disease. Major neurological (≥30 days), surgical and medical complications (CTCAE III–V) were observed in 8.2%, 13.7%, and 9.6%, respectively. The occurrence of a major complication markedly reduced survival (10.7 vs. 2.5 months, p = 0.020). The presence of extracerebral metastases did not significantly influence OS. Postponing staging was not associated with more complications or shorter survival. Together these data argue for individualized decision making which includes offering surgery in selected cases with a presumably adverse prognosis and also occasional urgent operations in cases without a preoperative oncological work-up. Complication avoidance is of utmost importance.

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“…Cancer is amongst the leading causes of death worldwide, causing nearly 10 million deaths in 2020, while metastases are the primary cause of cancer-related death [ 1 ]. Brain metastases (BM), in particular, are a frequent complication in patients with advanced cancer, with critical impact on neurological function, quality of life, prognosis and survival [ 2 , 3 ]. The types of cancer most frequently associated to brain metastases are lung, breast and skin (melanoma) [ 3 , 4 ] with lung and breast cancers being the two most frequently diagnosed cancers in the world [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Exosomes and Brain Metastases: A Review on Their Role and Potential Applications

Oliveira

Castanho

Neves

2021

IJMS

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Brain metastases (BM) are a frequent complication in patients with advanced stages of cancer, associated with impairment of the neurological function, quality of life, prognosis, and survival. BM treatment consists of a combination of the available cancer therapies, such as surgery, radiotherapy, chemotherapy, immunotherapy and targeted therapies. Even so, cancer patients with BM are still linked to poor prognosis, with overall survival being reported as 12 months or less. Intercellular communication has a pivotal role in the development of metastases, therefore, it has been extensively studied not only to better understand the metastization process, but also to further develop new therapeutic strategies. Exosomes have emerged as key players in intercellular communication being potential therapeutic targets, drug delivery systems (DDS) or biomarkers. In this Review, we focus on the role of these extracellular vesicles (EVs) in BM formation and their promising application in the development of new BM therapeutic strategies.

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The Management of Brain Metastases—Systematic Review of Neurosurgical Aspects

Cited by 29 publications

References 176 publications

Research Progress and Challenges in the Treatment of Central Nervous System Metastasis of Non-Small Cell Lung Cancer

Research Progress and Challenges in the Treatment of Central Nervous System Metastasis of Non-Small Cell Lung Cancer

Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues

Exosomes and Brain Metastases: A Review on Their Role and Potential Applications

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