Łupicka Aleksandra, Kowalczyk Weronika, Cyman Bartosz, Spałek Mateusz
The Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Warsaw, Poland.
The Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Wilhelma Konrada Roentgena 5, Warsaw 02-781, Poland.
Ther Adv Med Oncol. 2024 Oct 15;16:17588359241289203. doi: 10.1177/17588359241289203. eCollection 2024.
Brain metastases (BM) are the most common intracranial malignancies. They are responsible for death as well as impairment of quality of life and cognitive function. In some cases, BMs can cause intracranial hemorrhage, which is not only responsible for the acute onset of either a new focal neurological deficit or worsening of a preexisting focal deficit but also poses a new challenge in treatment planning and clinical management. The aim of this study was to evaluate the available treatment modalities and their efficacy in hemorrhagic brain metastases (HBMs) with special attention to radiotherapy. In this review, we searched PubMed, BMJ, NCBI, Springer, BMC Cancer, Cochrane, and Google Scholar for articles containing data on the diagnosis and treatment of patients with HBMs, excluding the pediatric population. Treatment strategies consist of neurosurgery, whole brain radiotherapy, and stereotactic techniques (fractionated stereotactic radiosurgery (fSRS)/stereotactic radiosurgery (SRS)). Although the optimal treatment strategy for HBMs has not been established, we found no convincing evidence that radiotherapy, especially fSRS/SRS, is contraindicated in HBMs. We concluded that fSRS/SRS is a promising option for patients with HBM, particularly when surgical intervention poses risks.
脑转移瘤（BM）是最常见的颅内恶性肿瘤。它们可导致死亡以及生活质量和认知功能受损。在某些情况下，脑转移瘤可引起颅内出血，这不仅会导致新的局灶性神经功能缺损急性发作或使先前存在的局灶性缺损恶化，还会给治疗计划和临床管理带来新的挑战。本研究的目的是评估现有治疗方式及其在出血性脑转移瘤（HBM）中的疗效，特别关注放射治疗。在本综述中，我们在PubMed、《英国医学杂志》（BMJ）、美国国立医学图书馆（NCBI）、施普林格、《BMC癌症》、考克兰图书馆和谷歌学术上搜索了包含HBM患者诊断和治疗数据的文章，不包括儿科人群。治疗策略包括神经外科手术、全脑放疗和立体定向技术（分次立体定向放射外科（fSRS）/立体定向放射外科（SRS））。尽管尚未确定HBM的最佳治疗策略，但我们没有发现令人信服的证据表明放疗，尤其是fSRS/SRS，在HBM中是禁忌的。我们得出结论，fSRS/SRS是HBM患者的一个有前景的选择，特别是在手术干预存在风险时。
