Hasanov Elshad, Yeboa Debra Nana, Tucker Mathew D, Swanson Todd A, Beckham Thomas Hendrix, Rini Brian, Ene Chibawanye I, Hasanov Merve, Derks Sophie, Smits Marion, Dudani Shaan, Heng Daniel Y C, Brastianos Priscilla K, Bex Axel, Hanalioglu Sahin, Weinberg Jeffrey S, Hirsch Laure, Carlo Maria I, Aizer Ayal, Brown Paul David, Bilen Mehmet Asim, Chang Eric Lin, Jaboin Jerry, Brugarolas James, Choueiri Toni K, Atkins Michael B, McGregor Bradley A, Halasz Lia M, Patel Toral R, Soltys Scott G, McDermott David F, Elder James Bradley, Baskaya Mustafa K, Yu James B, Timmerman Robert, Kim Michelle Miran, Mut Melike, Markert James, Beal Kathryn, Tannir Nizar M, Samandouras George, Lang Frederick F, Giles Rachel, Jonasch Eric
Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
CA Cancer J Clin. 2022 Sep;72(5):454-489. doi: 10.3322/caac.21729. Epub 2022 Jun 16.
Brain metastases are a challenging manifestation of renal cell carcinoma. We have a limited understanding of brain metastasis tumor and immune biology, drivers of resistance to systemic treatment, and their overall poor prognosis. Current data support a multimodal treatment strategy with radiation treatment and/or surgery. Nonetheless, the optimal approach for the management of brain metastases from renal cell carcinoma remains unclear. To improve patient care, the authors sought to standardize practical management strategies. They performed an unstructured literature review and elaborated on the current management strategies through an international group of experts from different disciplines assembled via the network of the International Kidney Cancer Coalition. Experts from different disciplines were administered a survey to answer questions related to current challenges and unmet patient needs. On the basis of the integrated approach of literature review and survey study results, the authors built algorithms for the management of single and multiple brain metastases in patients with renal cell carcinoma. The literature review, consensus statements, and algorithms presented in this report can serve as a framework guiding treatment decisions for patients. CA Cancer J Clin. 2022;72:454-489.
脑转移是肾细胞癌的一种具有挑战性的表现形式。我们对脑转移瘤及其免疫生物学、全身治疗耐药的驱动因素以及其总体较差的预后了解有限。目前的数据支持采用放疗和/或手术的多模式治疗策略。尽管如此，肾细胞癌脑转移的最佳管理方法仍不明确。为改善患者护理，作者试图规范实际管理策略。他们进行了非结构化文献综述，并通过国际肾癌联盟网络召集的来自不同学科的国际专家小组详细阐述了当前的管理策略。对来自不同学科的专家进行了一项调查，以回答与当前挑战和未满足的患者需求相关的问题。基于文献综述和调查研究结果的综合方法，作者构建了肾细胞癌患者单发和多发脑转移管理的算法。本报告中呈现的文献综述、共识声明和算法可作为指导患者治疗决策的框架。《CA：临床医师癌症杂志》。2022年；72：454 - 489。
