Brain metastatic lesions.

Abstract:

OBJECTIVE:To describe current concepts in the diagnosis and treatment of brain metastases. RESULTS:More than 25% of all autopsy-proven brain metastases have a pulmonary source. Most brain metastases manifest with a combination of focal and generalized symptoms and signs. Typically, patients have subacute, progressive symptoms. In most situations, a computed tomographic scan of the head provides sufficient neuroimaging and allows one to monitor the effects of therapy. Magnetic resonance imaging has become increasingly useful in the diagnosis and management of brain metastases. It can detect computed tomographic occult metastases, identify associated leptomeningeal disease, and reveal early therapeutic complications. CONCLUSION:Treatment options for patients with brain metastases include corticosteroids, whole-brain radiation therapy (WBRT), surgical intervention, stereotactic radiosurgical techniques, and chemotherapy. Corticosteroids produce prompt improvement in most patients; however, prolonged use is associated with considerable risks. For most patients, WBRT is the preferred treatment. Nonetheless, it has associated nonneurologic and neurologic complications, some of which are serious. In patients with a single metastasis, surgical removal should be considered. Recent studies have suggested that resection of a single metastatic lesion followed by radiation therapy offers better survival than does radiation therapy alone. The subsequent administration of WBRT after radiosurgical treatment has become standard practice. The role of chemotherapy is uncertain.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

O'Neill BP,Buckner JC,Coffey RJ,Dinapoli RP,Shaw EG

doi

10.1016/s0025-6196(12)61374-3

subject

Has Abstract

pub_date

1994-11-01 00:00:00

pages

1062-8

issue

11

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(12)61374-3

journal_volume

69

pub_type

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