Current multidisciplinary management of brain metastases

Michael J. Moravan, Peter E. Fecci, Carey K. Anders, Jeffrey M. Clarke, April K.S. Salama, Justus D. Adamson, Scott R. Floyd, Jordan A. Torok, Joseph K. Salama, John H. Sampson, Paul W. Sperduto, John P. Kirkpatrick

Research output: Contribution to journalReview articlepeer-review

73 Scopus citations

Abstract

Brain metastasis (BM), the most common adult brain tumor, develops in 20% to 40% of patients with late-stage cancer and traditionally are associated with a poor prognosis. The management of patients with BM has become increasingly complex because of new and emerging systemic therapies and advancements in radiation oncology and neurosurgery. Current therapies include stereotactic radiosurgery, whole-brain radiation therapy, surgical resection, laser-interstitial thermal therapy, systemic cytotoxic chemotherapy, targeted agents, and immune-checkpoint inhibitors. Determining the optimal treatment for a specific patient has become increasingly individualized, emphasizing the need for multidisciplinary discussions of patients with BM. Recognizing and addressing the sequelae of BMs and their treatment while maintaining quality of life and neurocognition is especially important because survival for patients with BMs has improved. The authors present current and emerging treatment options for patients with BM and suggest approaches for managing sequelae and disease recurrence.

Original languageEnglish
Pages (from-to)1390-1406
Number of pages17
JournalCancer
Volume126
Issue number7
DOIs
StatePublished - Apr 1 2020

Keywords

  • brain metastases
  • immunotherapy
  • laser-interstitial thermal therapy
  • radiation therapy
  • radionecrosis
  • stereotactic radiosurgery

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