Buczek Dagmara, Zaucha Renata, Jassem Jacek
Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland.
Front Oncol. 2024 Feb 2;13:1215426. doi: 10.3389/fonc.2023.1215426. eCollection 2023.
Breast cancer brain metastasis (BCBM) has a devastating impact on patient survival, cognitive function and quality of life. Radiotherapy remains the standard management of BM but may result in considerable neurotoxicity. Herein, we describe the current knowledge on methods for reducing radiation-induced cognitive dysfunction in patients with BCBM. A better understanding of the biology and molecular underpinnings of BCBM, as well as more sophisticated prognostic models and individualized treatment approaches, have appeared to enable more effective neuroprotection. The therapeutic armamentarium has expanded from surgery and whole-brain radiotherapy to stereotactic radiosurgery, targeted therapies and immunotherapies, used sequentially or in combination. Advances in neuroimaging have allowed more accurate screening for intracranial metastases, precise targeting of intracranial lesions and the differentiation of the effects of treatment from disease progression. The availability of numerous treatment options for patients with BCBM and multidisciplinary approaches have led to personalized treatment and improved therapeutic outcomes. Ongoing studies may define the optimal sequencing of available and emerging treatment options for patients with BCBM.
乳腺癌脑转移（BCBM）对患者的生存、认知功能和生活质量有着毁灭性的影响。放射治疗仍然是脑转移（BM）的标准治疗方法，但可能会导致相当严重的神经毒性。在此，我们描述了目前关于降低BCBM患者辐射诱导的认知功能障碍方法的知识。对BCBM生物学和分子基础的更好理解，以及更复杂的预后模型和个体化治疗方法，似乎能够实现更有效的神经保护。治疗手段已从手术和全脑放疗扩展到立体定向放射外科、靶向治疗和免疫治疗，可序贯使用或联合使用。神经影像学的进展使得对颅内转移瘤的筛查更加准确、对颅内病变的精确靶向以及区分治疗效果与疾病进展成为可能。BCBM患者有众多治疗选择以及多学科方法的应用，带来了个性化治疗并改善了治疗效果。正在进行的研究可能会确定BCBM患者现有和新出现治疗选择的最佳顺序。
