Brain metastases: a medical neuro-oncology perspective

Abstract

Brain metastases (BMs) are the most common neurological complication related to cancer. A review of recent and relevant literature relating to BMs was performed and found that the therapy of BMs remains controversial, notwithstanding numerous randomized clinical trials. Surgical resection of a solitary BM when possible, followed by whole-brain irradiation (WBI) is an established standard of care. More controversial is the substitution of stereotactic radiosurgery for surgery in the treatment of solitary BM. Treatment with WBI following local therapy remains controversial, with advocates for and against WBI. At present, systemic chemotherapy for BMs offers only very modest palliation. In summary, treatment of BMs remains contentious with respect to the utilization and timing of surgical resection, application of WBI and stereotactic radiosurgery, notwithstanding numerous randomized trials, as the range of interpretation of these trials has resulted in differing treatment perspectives.

Keywords::

• brain metastases
• oligometastatic
• polymetastatic
• solitary

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

Data from [6,47,67,69].

Data from [6,47,67,69].

Data from [25,27].