Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
Semin Neurol. 2010 Jul;30(3):217-35. doi: 10.1055/s-0030-1255225. Epub 2010 Jun 24.
Approximately 10% of patients with cancer develop brain metastases. Some evidence indicates that as techniques for treating systemic tumors improve, the incidence of brain metastases, sequestered as they are behind the blood-brain barrier, is increasing. Although usually appearing late in the course of the disease, a brain metastasis may cause the initial symptoms, before the primary cancer has been identified. The diagnostic and therapeutic approach depends on the number and location of brain lesions and the stage of the cancer. Patients with brain metastases are rarely cured. However, appropriate treatment can improve both the quality and duration of the patient's life. Treatment must be directed not only at the brain metastasis (definitive care), but also at a multitude of other symptoms that plague patients with brain metastases (supportive care). Judicious selection of pharmacologic agents and nonpharmacologic techniques can effectively treat many serious symptoms in patients with brain metastases, but injudicious selection of pharmacologic agents may have side effects and make the patient's quality of life worse. The authors review some aspects of both definitive and supportive care with particular attention to the side effects of some commonly used pharmacologic agents.
约 10%的癌症患者会发展为脑转移。一些证据表明，随着治疗全身肿瘤技术的提高，由于脑转移被血脑屏障所隔离，其发生率正在增加。尽管脑转移通常出现在疾病的晚期，但在原发性癌症被确定之前，脑转移可能会导致最初的症状。诊断和治疗方法取决于脑损伤的数量和位置以及癌症的分期。脑转移患者很少能被治愈。然而，适当的治疗可以提高患者的生活质量和延长其生存时间。治疗不仅必须针对脑转移（根治性治疗），还必须针对困扰脑转移患者的多种其他症状（支持性治疗）。明智地选择药物和非药物技术可以有效地治疗脑转移患者的许多严重症状，但药物选择不当可能会产生副作用，使患者的生活质量更差。作者回顾了根治性和支持性治疗的一些方面，特别关注一些常用药物的副作用。
