A multidisciplinary management algorithm for brain metastases

The incidence of brain metastases continues to present a management issue despite the advent of improved systemic control and overall survival. While the management of oligometastatic disease (ie, 1–4 brain metastases) with surgery and radiation has become fairly straightforward in the era of radios...

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Autores principales: Ramos, Alexander, Giantini-Larsen, Alexandra, Pannullo, Susan C, Brandmaier, Andrew, Knisely, Jonathan, Magge, Rajiv, Wilcox, Jessica A, Pavlick, Anna C, Ma, Barbara, Pisapia, David, Ashamalla, Hani, Ramakrishna, Rohan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Review
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749403/
https://www.ncbi.nlm.nih.gov/pubmed/36532509
http://dx.doi.org/10.1093/noajnl/vdac176
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author Ramos, Alexander
Giantini-Larsen, Alexandra
Pannullo, Susan C
Brandmaier, Andrew
Knisely, Jonathan
Magge, Rajiv
Wilcox, Jessica A
Pavlick, Anna C
Ma, Barbara
Pisapia, David
Ashamalla, Hani
Ramakrishna, Rohan
author_facet Ramos, Alexander
Giantini-Larsen, Alexandra
Pannullo, Susan C
Brandmaier, Andrew
Knisely, Jonathan
Magge, Rajiv
Wilcox, Jessica A
Pavlick, Anna C
Ma, Barbara
Pisapia, David
Ashamalla, Hani
Ramakrishna, Rohan
author_sort Ramos, Alexander
collection PubMed
description The incidence of brain metastases continues to present a management issue despite the advent of improved systemic control and overall survival. While the management of oligometastatic disease (ie, 1–4 brain metastases) with surgery and radiation has become fairly straightforward in the era of radiosurgery, the management of patients with multiple metastatic brain lesions can be challenging. Here we review the available evidence and provide a multidisciplinary management algorithm for brain metastases that incorporates the latest advances in surgery, radiation therapy, and systemic therapy while taking into account the latest in precision medicine-guided therapies. In particular, we argue that whole-brain radiation therapy can likely be omitted in most patients as up-front therapy.
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spelling pubmed-97494032022-12-15 A multidisciplinary management algorithm for brain metastases Ramos, Alexander Giantini-Larsen, Alexandra Pannullo, Susan C Brandmaier, Andrew Knisely, Jonathan Magge, Rajiv Wilcox, Jessica A Pavlick, Anna C Ma, Barbara Pisapia, David Ashamalla, Hani Ramakrishna, Rohan Neurooncol Adv Review The incidence of brain metastases continues to present a management issue despite the advent of improved systemic control and overall survival. While the management of oligometastatic disease (ie, 1–4 brain metastases) with surgery and radiation has become fairly straightforward in the era of radiosurgery, the management of patients with multiple metastatic brain lesions can be challenging. Here we review the available evidence and provide a multidisciplinary management algorithm for brain metastases that incorporates the latest advances in surgery, radiation therapy, and systemic therapy while taking into account the latest in precision medicine-guided therapies. In particular, we argue that whole-brain radiation therapy can likely be omitted in most patients as up-front therapy. Oxford University Press 2022-11-30 /pmc/articles/PMC9749403/ /pubmed/36532509 http://dx.doi.org/10.1093/noajnl/vdac176 Text en © The Author(s) 2022. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Ramos, Alexander
Giantini-Larsen, Alexandra
Pannullo, Susan C
Brandmaier, Andrew
Knisely, Jonathan
Magge, Rajiv
Wilcox, Jessica A
Pavlick, Anna C
Ma, Barbara
Pisapia, David
Ashamalla, Hani
Ramakrishna, Rohan
A multidisciplinary management algorithm for brain metastases
title A multidisciplinary management algorithm for brain metastases
title_full A multidisciplinary management algorithm for brain metastases
title_fullStr A multidisciplinary management algorithm for brain metastases
title_full_unstemmed A multidisciplinary management algorithm for brain metastases
title_short A multidisciplinary management algorithm for brain metastases
title_sort multidisciplinary management algorithm for brain metastases
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749403/
https://www.ncbi.nlm.nih.gov/pubmed/36532509
http://dx.doi.org/10.1093/noajnl/vdac176
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