Harvard Radiation Oncology Program, Boston, Massachusetts, USA.
Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts, USA.
Neuro Oncol. 2021 Sep 1;23(9):1447-1456. doi: 10.1093/neuonc/noab101.
Brain metastases affect a significant percentage of patients with advanced extracranial malignancies. Yet, the incidence of brain metastases remains poorly described, largely due to limitations of population-based registries, a lack of mandated reporting of brain metastases to federal agencies, and historical difficulties with delineation of metastatic involvement of individual organs using claims data. However, in 2016, the Surveillance Epidemiology and End Results (SEER) program released data relating to the presence vs absence of brain metastases at diagnosis of oncologic disease. In 2020, studies demonstrating the viability of utilizing claims data for identifying the presence of brain metastases, date of diagnosis of intracranial involvement, and initial treatment approach for brain metastases were published, facilitating epidemiologic investigations of brain metastases on a population-based level. Accordingly, in this review, we discuss the incidence, clinical presentation, prognosis, and management patterns of patients with brain metastases. Leptomeningeal disease is also discussed. Considerations regarding individual tumor types that commonly metastasize to the brain are provided.
脑转移影响了很大比例的晚期颅外恶性肿瘤患者。然而，脑转移的发病率仍描述得很差，主要是由于人群登记处的局限性、缺乏向联邦机构报告脑转移的规定、以及使用索赔数据来划定单个器官的转移受累情况的历史困难。然而，2016 年，监测、流行病学和最终结果（SEER）计划发布了与肿瘤疾病诊断时是否存在脑转移相关的数据。2020 年，发表了利用索赔数据来确定脑转移的存在、颅内受累的诊断日期以及脑转移初始治疗方法的可行性的研究，从而促进了基于人群的脑转移的流行病学研究。因此，在这篇综述中，我们讨论了脑转移患者的发病率、临床表现、预后和管理模式。也讨论了脑膜疾病。提供了关于常见脑转移的个别肿瘤类型的注意事项。
