Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Hematol Oncol Clin North Am. 2023 Feb;37(1):183-202. doi: 10.1016/j.hoc.2022.08.017.
The management of patients with breast cancer and brain metastases (BMs) is exquisitely multidisciplinary. Patients presenting with a symptomatic BM may be offered neurosurgical resection, followed by radiation. Stereotactic radiosurgery (SRS) is preferred over whole-brain radiotherapy (WBRT) in most patients presenting with a limited number of BMs, whereas WBRT with hippocampal-sparing and concomitant memantine is preferred for patients with multiple BMs. There is a growing role for systemic therapy, in some cases in lieu of local therapy, particularly in patients with HER2+ breast cancer.
乳腺癌伴脑转移（BM）患者的管理需要多学科的精湛技术。对于有症状性 BM 的患者，可以考虑神经外科切除，然后进行放疗。对于大多数有少量 BM 的患者，立体定向放射外科（SRS）优于全脑放疗（WBRT），而对于多发性 BM 的患者，WBRT 联合海马保护和伴随美金刚则更为合适。在某些情况下，系统治疗，特别是曲妥珠单抗治疗人表皮生长因子受体 2（HER2）阳性乳腺癌，在替代局部治疗方面的作用越来越大。
