Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada.
Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Can J Neurol Sci. 2021 Mar;48(2):189-197. doi: 10.1017/cjn.2020.224. Epub 2020 Oct 12.
Brain metastases (BM) are the most common intracranial neoplasm and represent a major clinical challenge across many medical disciplines. The incidence of BM is increasing, largely due to improvements in primary disease therapeutics conferring greater systemic control, and advancements in neuroimaging techniques and availability leading to earlier diagnosis. In recent years, the landscape of BM treatment has changed significantly with the advent of personalized targeted chemotherapies and immunotherapy, the adoption of focal radiotherapy (RT) for higher intracranial disease burden, and the implementation of new surgical strategies. The increasing permutations of options available for the treatment of patients diagnosed with BM necessitate coordinated care by a multidisciplinary team. This review discusses the current treatment regimens for BM as well as examines the salient features of a modern multidisciplinary approach.
脑转移瘤(BM)是最常见的颅内肿瘤,代表了许多医学学科面临的重大临床挑战。BM 的发病率正在上升,这主要是由于原发性疾病治疗方法的改进带来了更好的全身控制效果,以及神经影像学技术和可用性的进步带来了更早的诊断。近年来,随着个性化靶向化疗和免疫疗法的出现,以及更高颅内疾病负担的局部放射治疗(RT)的采用,以及新的手术策略的实施,BM 治疗领域发生了重大变化。可供诊断为 BM 的患者选择的治疗方案的排列组合越来越多,这需要多学科团队的协调护理。这篇综述讨论了目前 BM 的治疗方案,并检查了现代多学科方法的显著特征。