Willman Matthew, Willman Jonathan, Lucke-Wold Brandon
Department of Neurosurgery, University of Florida, Gainesville, FL 32610-0265, USA.
Explor Target Antitumor Ther. 2022;3(2):240-251. doi: 10.37349/etat.2022.00081. Epub 2022 Apr 26.
Endocrine resistant breast cancer metastasis continues to serve as a significant clinical challenge with high morbidity and mortality for patients. As the number of breast cancer cases continues to rise, the rate of brain metastasis has also increased. For single lesions or a large symptomatic lesion with other smaller lesions, surgical resection is a viable option in non-eloquent regions. Stereotactic radiosurgery is a great option for post-operative therapy or for 10 or fewer small lesions (< 3 cm in size). Whole-brain radiation can be used sparingly for large tumor burdens but should encompass hippocampus sparing techniques. Chemotherapy options have remained relatively limited due to decreased permeability of the blood-brain barrier. Emerging monoclonal antibody treatments have offered initial promise, especially for endocrine resistant breast cancer metastasis.
内分泌抵抗性乳腺癌转移仍然是一个重大的临床挑战，给患者带来高发病率和死亡率。随着乳腺癌病例数量持续上升，脑转移率也有所增加。对于单个病灶或伴有其他较小病灶的大型有症状病灶，在非功能区进行手术切除是一种可行的选择。立体定向放射外科手术对于术后治疗或10个或更少的小病灶（尺寸<3厘米）是一个很好的选择。对于肿瘤负荷较大的情况，全脑放疗可谨慎使用，但应采用海马体保护技术。由于血脑屏障通透性降低，化疗选择仍然相对有限。新兴的单克隆抗体治疗已展现出初步前景，尤其是对于内分泌抵抗性乳腺癌转移。
