Grau S, Herling M, Mauch C, Galldiks N, Golla H, Schlamann M, Scheel A H, Celik E, Ruge M, Goldbrunner R
Klinik für Allgemeine Neurochirurgie, Universität zu Köln, Medizinische Fakultät, Klinikum der Universität, Kerpener Str. 62, 50937, Köln, Deutschland.
Centrum für Integrierte Onkologie (CIO) Aachen Bonn Köln Düsseldorf, Universität zu Köln, Medizinische Fakultät, Klinikum der Universität, Köln, Deutschland.
Chirurg. 2021 Mar;92(3):200-209. doi: 10.1007/s00104-020-01344-y. Epub 2021 Jan 27.
The incidence, treatment and prognosis of patients with brain metastases have substantially changed during the last decades. While the survival time after diagnosis of cerebral metastases was on average a maximum of 3-6 months only 10 years ago, the survival time could be significantly improved due to novel surgical, radiotherapeutic and systemic treatment modalities. Only a few years ago, the occurrence of brain metastases led to a withdrawal from systemic oncological treatment and the exclusion of drug therapy studies and to a purely palliatively oriented treatment in the sense of whole brain radiation therapy (WBRT) with or without surgery. The increasing availability of targeted and immunomodulatory drugs as well as adapted radio-oncological procedures enable increasingly more personalized treatment approaches. The aim of this review article is to demonstrate the progress and complexity of the treatment of brain metastases in the context of modern comprehensive interdisciplinary concepts.
在过去几十年中,脑转移瘤患者的发病率、治疗方法和预后发生了显著变化。仅在10年前,脑转移瘤诊断后的平均生存时间最多为3至6个月,而由于新型手术、放射治疗和全身治疗方式,生存时间得到了显著改善。就在几年前,脑转移瘤的出现导致患者退出全身肿瘤治疗,被排除在药物治疗研究之外,并且只能接受单纯以姑息治疗为导向的全脑放射治疗(WBRT),无论是否进行手术。靶向药物和免疫调节药物的可及性不断提高,以及放射肿瘤学程序的改进,使得个性化治疗方法越来越多。这篇综述文章的目的是在现代综合跨学科概念的背景下,展示脑转移瘤治疗的进展和复杂性。