Current Standards in the Management of Cerebral Metastases

Goetz, Pablo; Ebinu, Julius O.; Roberge, David; Zadeh, Gelareh

doi:10.1155/2012/493426

Cited by 10 publications

(13 citation statements)

References 69 publications

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“…Contrary to previously held beliefs, these patients do have sufficient time to develop the neurocognitive side effects associated with WBRT and should be considered for more focal therapies like surgery and SRS in select cases. Though WBRT may improve the short term neurological symptoms associated with brain metastasis and prevent the development of further metastases in the short term, it has not been shown to significantly improve survival as an independent treatment modality (14,15). In patients with a single, resectable lesion, there is a survival benefit associated with surgery followed by WBRT compared to WBRT alone (16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

“…The value of SRS in the treatment of brain metastases, particularly in unresectable lesions, has also been established (14). Specifically, WBRT with SRS boost compared to WBRT alone is associated with improved local control in patients with small lesions (generally ≤3 cm) or a small number of metastases (20,21).…”

Section: Discussionmentioning

confidence: 99%

“…Class I patients, with the best predicted survival, are defined as <65 years, having a KPS ≥70, and having no extracranial metastasis; class III patients, with the worst predicted survival, are defined as having KPS <70; and, class II patients are all others (12). Stratification by RPA can help evaluate the benefit of aggressive treatments for patients with better prognosis (RPA class I or II) (14).…”

Section: Introductionmentioning

confidence: 99%

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Outcomes in patients with brain metastasis from esophageal carcinoma.

Saeed

Kothari

Mellon

et al. 2016

JCO

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Background: Brain metastases from esophageal carcinoma have historically been rare and associated with poor prognosis. With improvements in systemic disease control, the incidence of brain metastases is expected to rise. To better inform management decisions, we sought to identify factors associated with survival in patients with brain metastasis from esophageal cancer. Conclusions: While the prognosis for esophageal cancer metastatic to brain remains poor overall, we found that patients with good performance status and limited number of brain lesions have superior survival.Aggressive management may further improve outcomes in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes in patients with brain metastasis from esophageal carcinoma.

Saeed

Kothari

Mellon

et al. 2016

JCO

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“…In 15% of patients, BM are responsible for the presenting symptoms of cancer and at the time neurological symptoms develop more than 70% of patients have multiple lesions on MRI [10].…”

Section: Abstract: Brain Metastasis • Salvage Treatment • Stereotactimentioning

confidence: 99%

Salvage stereotactic radiosurgery for brain metastases

Klironomos¹,

Bernstein²

2013

Expert Review of Neurotherapeutics

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Recurrent or progressive brain metastases after initial treatment represent a common clinical entity mainly due to increased survival of cancer patients. From the various available treatment modalities, salvage stereotactic radiosurgery seems to be the most commonly used. Many clinical studies of class of evidence III have demonstrated satisfied results concerning the local brain control and survival of patients with relapsing brain disease. Also stereotactic radiosurgery is considered a relatively safe modality with low incidence of brain toxicity side effects. It is obvious that well-designed, randomized, prospective studies are necessary for the evaluation of the stereotactic radiosurgery as salvage treatment and for the establishment of guidelines for the selection of patients most suitable for this treatment option. The increasing number of patients with relapsing brain metastatic disease will act as a pressure to this direction.

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“…(22,23) Patients suffering from brain metastases are living longer and thus the management of these patients has become increasingly complex.…”

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confidence: 99%