Brain metastases |
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Authors: | Wen P Y Loeffler J S |
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Institution: | (1) Division of Neuro-oncology, Department of Neurology, Brigham and Women's Hospital, 75 Francis Street, 02115 Boston, MA, USA;(2) Northeast Proton Therapy Center, Massachusetts General Hospital, Fruit Street, 02114 Boston, MA, USA |
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Abstract: | Opinion statement Brain metastases are an increasingly common complication in patients with systemic cancer. The optimal treatment for each
patient depends on careful evaluation of several factors: the location, size, and number of brain metastases; the patient's
age, general condition, and neurologic status; and the extent of systemic cancer to name a few. For patients with a single
brain metastasis and limited systemic disease, the standard treatment is surgical resection followed by whole brain radiation
therapy. In patients with a small, single metastasis, stereotactic radiosurgery is probably comparable to surgery. Patients
with several metastases (up to three) and controlled systemic disease can be treated with whole-brain radiation and stereotactic
radiosurgery. Patients with multiple metastases (more than three) are generally treated with whole-brain radiation alone.
Radiosurgery is effective in treating patients with a limited number of recurrent brain metastases and stable systemic diseases.
Surgery may have a role in patients with a large symptomatic recurrent lesion producing mass effect. Reirradiation and chemotherapy
may have a limited role in patients with multiple recurrent metastases. |
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Keywords: | |
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