脑转移瘤的外科治疗：挑战与细微差别
Surgical Management of Brain Metastasis: Challenges and Nuances.
作者信息
Ene Chibawanye I, Ferguson Sherise D
机构信息
Department of Neurosurgery, University of Texas, MD Anderson Cancer Center, Houston, TX, United States.
出版信息
Front Oncol. 2022 Mar 14;12:847110. doi: 10.3389/fonc.2022.847110. eCollection 2022.
Abstract
Brain metastasis is the most common type of intracranial tumor. The contemporary management of brain metastasis is a challenging issue and traditionally has carried a poor prognosis as these lesions typically occur in the setting of advanced cancer. However, improvement in systemic therapy, advances in radiation techniques and multimodal therapy tailored to the individual patient, has given hope to this patient population. Surgical resection has a well-established role in the management of brain metastasis. Here we discuss the evolving role of surgery in the treatment of this diverse patient population.
摘要
脑转移瘤是最常见的颅内肿瘤类型。脑转移瘤的现代治疗是一个具有挑战性的问题，传统上其预后较差，因为这些病变通常发生在晚期癌症的背景下。然而，全身治疗的改善、放射技术的进步以及针对个体患者的多模式治疗，给这一患者群体带来了希望。手术切除在脑转移瘤的治疗中具有既定的作用。在此，我们讨论手术在治疗这一多样化患者群体中不断演变的作用。
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2
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Neurosurg Clin N Am. 2020 Oct;31(4):575-587. doi: 10.1016/j.nec.2020.06.007. Epub 2020 Aug 14.
3
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Cancer Med. 2020 Oct;9(20):7503-7510. doi: 10.1002/cam4.3402. Epub 2020 Aug 28.
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