The management of cerebral metastasis

Central nervous system (CNS) metastases are a common clinical problem, and management spans the three major therapeutic disciplines in oncology. Surgery, radiotherapy, and chemotherapy are employed alone, in combination, or sequentially and are based on four local factors--the number, size, site, and depth of the lesions; and three tumor factors--the natural or biologic history of the primary tumor, the quantitative host tumor burden, and the tumor responsiveness to individual therapeutic modalities. The median survival of patients with CNS metastasis is 3 to 12 months and is not necessarily compromised by the CNS lesions, if the diagnosis is established and therapy promptly instituted.