Shapiro Daniela Gonsalves, Samlowski Wolfram E
Section of Melanoma, Renal Cancer and Immunotherapy, Nevada Cancer Institute, One Breakthrough Way, Las Vegas, NV 89135, USA.
J Skin Cancer. 2011;2011:845863. doi: 10.1155/2011/845863. Epub 2011 Dec 15.
Disseminated metastatic disease, including brain metastases, is commonly encountered in malignant melanoma. The classical treatment approach for melanoma brain metastases has been neurosurgical resection followed by whole brain radiotherapy. Traditionally, if lesions were either too numerous or surgical intervention would cause substantial neurologic deficits, patients were either treated with whole brain radiotherapy or referred to hospice and supportive care. Chemotherapy has not proven effective in treating brain metastases. Improvements in surgery, radiosurgery, and new drug discoveries have provided a wider range of treatment options. Additionally, recently discovered mutations in the melanoma genome have led to the development of "targeted therapy." These vastly improved options are resulting in novel treatment paradigms for approaching melanoma brain metastases in patients with and without systemic metastatic disease. It is therefore likely that improved survival can currently be achieved in at least a subset of melanoma patients with brain metastases.
播散性转移性疾病，包括脑转移，在恶性黑色素瘤中很常见。黑色素瘤脑转移的传统治疗方法是神经外科切除，然后进行全脑放疗。传统上，如果病变数量过多或手术干预会导致严重的神经功能缺损，患者要么接受全脑放疗，要么被转诊至临终关怀和支持性护理机构。化疗尚未被证明对治疗脑转移有效。手术、放射外科手术的改进以及新药物的发现提供了更广泛的治疗选择。此外，最近在黑色素瘤基因组中发现的突变导致了“靶向治疗”的发展。这些大大改进的选择正在为有或没有全身转移性疾病的患者提供治疗黑色素瘤脑转移的新治疗模式。因此，目前至少在一部分患有脑转移的黑色素瘤患者中可能实现生存率的提高。
