The treatment of Brain Metastases is palliative and it is ignored the ideal therapeutic combination, constituting this a controversial topic. Objective: To determine the results of the treatment to patient with Brain Metastases according to different modalities. Method: It was carried out a prospective cohort study between april 2010 to april 2013 in the National Institute of Oncology and Radiobiology. It was designated as universe the total of patient with diagnosis of Brain Metastases of primary tumor assisted in consultation of Neurosurgery. The Fischer exact test was used to correlate qualitative variables and the Kaplan Meier curvesto estimate the survival. Results: It was obtained a sample of 42 patients and 84 lesions. The age average was of 53,1 years. The primary lesions prevailed in lung and breast. The used modalities were: Surgery-Whole Brain Radiation Therapy (20 lesions), Whole Brain Radiation Therapy alone (29 lesions), Radiosurgery alone (21 lesions) and Surgery alone (9 lesions). Conclusions: The combinations of Radiosurgery-Whole Brain Radiation Therapy and Surgery-Radiosurgery associated to a better local control. The treatment with Whole Brain Radiation Therapy didn't associate to a better distance control. The overall survival to the 6 months was of 91% and to the 12 months of 57%. A bigger survival was observed in patient with controlled primary illness and absence of extracraneal metastases. The Surgery presents the biggest number of complications.
Cerebellar pilocytic astrocytoma represent a benign tumor Minimally invasive surgery constitutes a good alternative in selected patients.Intravenous fluoresceinsodium improves delineation and resection of the lesion.
Rhabdomyosarcoma is a rare soft tissue malignancy derived from myogenic cells. There is very little literature that provides substantial evidence regarding the outcomes of surgical treatment of parameningeal subtype. Endonasal endoscopic resection offers a faster recovery with minimal morbidity, providing a better life quality and immediately adjuvant treatment. Minimally invasive pericranial flap constitute a good alternative in cases with non-viable mucosal vascularized nasoseptal flap. Multimodal treatment ae essential.
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