Roche Diagnostics GmbH, Pharma Research Penzberg, Nonnenwald 2, 82377 Penzberg, Germany.
Expert Rev Anticancer Ther. 2010 Nov;10(11):1763-77. doi: 10.1586/era.10.165.
Metastases of various tumors to the brain account for the majority of brain cancers, and are associated with a poor prognosis. The most common primary sites are lung, breast, skin, kidney and colon; 10-40% of cancer patients develop brain metastases during the course of the disease. The incidence of brain metastasis appears to be rising; reasons may include better therapies for the systemic disease with longer survival of cancer patients but lower efficiency against brain metastases. In this article, we will discuss the conventional treatment with surgery, radiosurgery, radiotherapy and chemotherapy, but also new directions in the management of solid brain metastases. While general therapeutic nihilism should be avoided, it is important to recognize that the number of brain metastases, the extent of the systemic disease and also the tumor type have to be taken into account when choosing individual treatment regimens. Finally, special emphasis will be put on established and future approaches to prevent the disease. We thus aim to provide a framework for treating patients with different presentations of brain metastases, and to highlight important avenues for research.
各种肿瘤的脑转移占大多数脑癌，预后不良。最常见的原发性部位是肺、乳腺、皮肤、肾和结肠；10-40%的癌症患者在疾病过程中发生脑转移。脑转移的发生率似乎在上升；原因可能包括对全身疾病的更好治疗，癌症患者的生存时间延长，但对脑转移的效果较低。在本文中，我们将讨论常规的治疗方法，包括手术、放射外科、放疗和化疗，以及脑转移瘤管理的新方向。虽然应避免普遍的治疗虚无主义，但在选择个体化治疗方案时，必须考虑脑转移的数量、全身疾病的程度以及肿瘤类型。最后，我们将特别强调预防这种疾病的既定和未来方法。因此，我们旨在为治疗不同表现的脑转移患者提供一个框架，并强调研究的重要途径。
