| Metastatic brain tumors |
| Dong-Sup Chung, Yong-Kil Hong |
| Department of Neurosurgery, The Catholic University of Korea College of Medicine, Seoul, Korea |
| 전이성 뇌종양 |
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정동섭, 홍영길 |
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가톨릭대학교 의과대학 이비인후과학교실 |
| Corresponding Author:
Yong-Kil Hong ,Tel: +82-2-590-1450, Fax: +82-2-536-1454, Email: hongyk@catholic.ac.kr |
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Received: May 3, 2008; Accepted: May 19, 2008. |
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| ABSTRACT |
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The incidence of brain metastasis is increasing because of longer survival of cancer patients as a result of the increase in early
diagnosis of primary cancers, aggressive and advanced management, and improvements in imaging quality and accessibility.
Contrast-enhanced MRI is now the gold standard for the diagnosis. Good prognostic factors for metastatic brain tumor are a high
performance status, a solitary metastasis, an absence of systemic metastases, a controlled primary tumor and young age. The goal
of treatment is to palliate local symptoms and prevent consequences of neurological involvement. Management consists of generalized
supportive care and tumor directed treatment. Surgical resection is considered the treatment of choice for solitary brain
metastasis. Whole brain radiation therapy (WBRT) remains standard treatment for all patients with brain metastases. The combination
of surgery and WBRT is superior to WBRT alone. Radiosurgery offers the potential of treating patients with surgically inaccessible
metastases. WBRT in conjunction with surgery or radiosurgery improves local control and reduces the risk of tumor relapse,
but does not improve the overall survival. Therefore, there is an increasing tendency to omit adjuvant WBRT for reserving salvage
treatment at recurrence. Although the role of chemotherapy for brain metastases still remains controversial, a new generation drugs
like temozolomide and topotecan have antitumor activity against the brain metastases as well as the primary tumors. New radiosensitizers,
cytotoxic or biologic agents and techniques of drug delivery are being investigated.. |
| Keywords:
Brain metastases | Surgery | Radiosurgery | Whole brain radiation therapy | Chemotherapy |
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