Abstract:
:The clinical management/understanding of brain metastases (BM) has changed substantially in the last 5 years, with key advances and clinical trials highlighted in this review. Several of these changes stem from improvements in systemic therapy, which have led to better systemic control and longer overall patient survival, associated with increased time at risk for developing BM. Development of systemic therapies capable of preventing BM and controlling both intracranial and extracranial disease once BM are diagnosed is paramount. The increase in use of stereotactic radiosurgery alone for many patients with multiple BM is an outgrowth of the desire to employ treatments focused on local control while minimizing cognitive effects associated with whole brain radiotherapy. Complications from BM and their treatment must be considered in comprehensive patient management, especially with greater awareness that the majority of patients do not die from their BM. Being aware of significant heterogeneity in prognosis and therapeutic options for patients with BM is crucial for appropriate management, with greater attention to developing individual patient treatment plans based on predicted outcomes; in this context, recent prognostic models of survival have been extensively revised to incorporate molecular markers unique to different primary cancers.
journal_name
Neuro Oncoljournal_title
Neuro-oncologyauthors
Arvold ND,Lee EQ,Mehta MP,Margolin K,Alexander BM,Lin NU,Anders CK,Soffietti R,Camidge DR,Vogelbaum MA,Dunn IF,Wen PYdoi
10.1093/neuonc/now127subject
Has Abstractpub_date
2016-08-01 00:00:00pages
1043-65issue
8eissn
1522-8517issn
1523-5866pii
now127journal_volume
18pub_type
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