- 1-800-248-1199
Brain Metastases
|
Roughly one half of the cancerous tumors that occur in the brain originated in the brain and are called primary malignant brain tumors. The other half actually started somewhere else in the body, such as the lung or breast, and eventually spread to the brain through the bloodstream. These cancerous tumors are called brain metastases. Historically, the appearance of brain metastases has been considered a most ominous sign as both a threat to the patient's quality of life and an indicator of impending death from cancer. With new treatment approaches, however, survival after diagnosis of brain metastases can be both longer and with more quality. The most common treatment for brain metastases, whether single or multiple, is whole brain radiotherapy (WBR). The ability of this therapy to control the brain tumors ranges between 50-70% for the remaining lifespan of the patient depending on the site of origin and health of the patient. In 1990, a randomized study of patients with a solitary brain metastasis was published comparing WBR alone versus WBR plus surgical resection (removal) of the tumor (reference 1). This study suggested that the more "aggressive" treatment including surgery resulted in longer median survival (3.75 months versus 10 months) as well as extended functional independence. Subsequent retrospective studies have suggested that the less invasive Gamma Knife radiosurgery can substitute for surgical resection with equivalent results (references 2-3). In addition, Gamma Knife treatment of a limited number of multiple metastases is quite feasible without prohibitive side effects. There is currently controversy in the medical community regarding who should be treated after initial diagnosis of brain metastases with WBR alone and who should be offered additional therapies including Gamma Knife radiosurgery and surgical resection. Patients with solitary lesions who have a reasonably high performance status (i.e. can care for themselves) were eligible for the randomized study noted above and, hence, should be considered for surgical resection or radiosurgery. Patients with very radiosensitive tumors (e.g. small cell lung cancer, germ cell tumors, lymphomas, and leukemias) may only need WBR. Patients with multiple metastases should be offered additional therapies based on the likelihood of extended survival. Factors that may contribute to such a determination include performance status, overall health, neurological impairment, and status of the cancer outside the brain. Patients with recurrent brain metastases or additional brain metastases appearing after the initial diagnosis may be candidates for further therapy. If WBR was not used initially, it should be considered. Otherwise, Gamma Knife radiosurgery or surgical resection may be reasonable treatments depending on similar factors as listed above.
[Keywords: malignant brain tumor, cancerous tumor, whole brain radiotherapy, WBR, surgical resection, radiosurgery, radiosensitive tumors, small cell lung cancer, germ cell tumors, lymphomas, leukemias] |
|
|
Copyright © 2000-2010 Web Design: NetMediaOne |
