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Review of Current Principles of the Diagnosis and Management of Brain Metastases

Brain metastases are the most common intracranial tumors and are increasing in incidence as overall cancer survival improves. Diagnosis of brain metastases involves both clinical examination and magnetic resonance imaging. Treatment may involve a combination of surgery, radiotherapy, and systemic me...

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Detalles Bibliográficos
Autores principales: Brenner, Alex W., Patel, Akash J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9171239/
https://www.ncbi.nlm.nih.gov/pubmed/35686091
http://dx.doi.org/10.3389/fonc.2022.857622
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author Brenner, Alex W.
Patel, Akash J.
author_facet Brenner, Alex W.
Patel, Akash J.
author_sort Brenner, Alex W.
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description Brain metastases are the most common intracranial tumors and are increasing in incidence as overall cancer survival improves. Diagnosis of brain metastases involves both clinical examination and magnetic resonance imaging. Treatment may involve a combination of surgery, radiotherapy, and systemic medical therapy depending on the patient’s neurologic status, performance status, and overall oncologic burden. Advances in these domains have substantially impacted the management of brain metastases and improved performance status and survival for some patients. Indications for surgery have expanded with improved patient selection, imaging, and intraoperative monitoring. Robust evidence supports the use of whole brain radiotherapy and stereotactic radiosurgery, for both standalone and adjuvant indications, in almost all patients. Lastly, while systemic medical therapy has historically provided little benefit, modern immunotherapeutic agents have demonstrated promise. Current investigation seeks to determine the utility of neoadjuvant radiotherapy and laser interstitial thermal therapy, which have shown benefit in limited studies to date. This article provides a review of the epidemiology, pathology, diagnosis, and treatment of brain metastases and the corresponding supporting evidence.
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spelling pubmed-91712392022-06-08 Review of Current Principles of the Diagnosis and Management of Brain Metastases Brenner, Alex W. Patel, Akash J. Front Oncol Oncology Brain metastases are the most common intracranial tumors and are increasing in incidence as overall cancer survival improves. Diagnosis of brain metastases involves both clinical examination and magnetic resonance imaging. Treatment may involve a combination of surgery, radiotherapy, and systemic medical therapy depending on the patient’s neurologic status, performance status, and overall oncologic burden. Advances in these domains have substantially impacted the management of brain metastases and improved performance status and survival for some patients. Indications for surgery have expanded with improved patient selection, imaging, and intraoperative monitoring. Robust evidence supports the use of whole brain radiotherapy and stereotactic radiosurgery, for both standalone and adjuvant indications, in almost all patients. Lastly, while systemic medical therapy has historically provided little benefit, modern immunotherapeutic agents have demonstrated promise. Current investigation seeks to determine the utility of neoadjuvant radiotherapy and laser interstitial thermal therapy, which have shown benefit in limited studies to date. This article provides a review of the epidemiology, pathology, diagnosis, and treatment of brain metastases and the corresponding supporting evidence. Frontiers Media S.A. 2022-05-24 /pmc/articles/PMC9171239/ /pubmed/35686091 http://dx.doi.org/10.3389/fonc.2022.857622 Text en Copyright © 2022 Brenner and Patel https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Brenner, Alex W.
Patel, Akash J.
Review of Current Principles of the Diagnosis and Management of Brain Metastases
title Review of Current Principles of the Diagnosis and Management of Brain Metastases
title_full Review of Current Principles of the Diagnosis and Management of Brain Metastases
title_fullStr Review of Current Principles of the Diagnosis and Management of Brain Metastases
title_full_unstemmed Review of Current Principles of the Diagnosis and Management of Brain Metastases
title_short Review of Current Principles of the Diagnosis and Management of Brain Metastases
title_sort review of current principles of the diagnosis and management of brain metastases
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9171239/
https://www.ncbi.nlm.nih.gov/pubmed/35686091
http://dx.doi.org/10.3389/fonc.2022.857622
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