Department of Neurological Surgery, Weill Cornell Medical College, Manhattan, New York, NY, USA.
J Clin Neurosci. 2013 Jun;20(6):771-5. doi: 10.1016/j.jocn.2012.09.026. Epub 2013 Apr 28.
Brain metastasis is a common complication of systemic cancer and significant cause of suffering in oncology patients. Despite a plethora of available treatment modalities, the prognosis is poor with a median survival time of approximately one year. For patients with controlled systemic disease, good performance status, and a limited number of metastases, treatment typically entails surgical resection or radiosurgery, followed by whole brain radiotherapy (WBRT) to control microscopic disease. WBRT is known to control the progression of cancer in the brain, but it can also have toxic effects, particularly with regard to neurocognition. There is no consensus as to whether the benefit of WBRT outweighs the potential harm. We review the evidence related to the question of whether patients undergoing surgical resection of brain metastases should receive adjuvant WBRT.
脑转移是系统性癌症的常见并发症，也是肿瘤患者痛苦的重要原因。尽管有多种治疗方法，但预后仍然很差，中位生存时间约为一年。对于全身疾病控制良好、表现状态良好且转移灶数量有限的患者，治疗通常需要手术切除或放射外科手术，然后进行全脑放疗（WBRT）以控制微转移灶。WBRT 可控制脑内癌症的进展，但也可能有神经认知方面的毒性作用。目前尚无共识认为 WBRT 的益处是否超过潜在危害。我们回顾了与脑转移瘤患者是否应接受辅助 WBRT 相关的证据。
