[Guidelines for the diagnosis and management of brain metastases]

Brain metastases are one of the most common palliative oncologic problems. Approximately 20% to 40% of all cancer patients eventually develop metastases to the brain. In this review, we discuss the clinical presentation, diagnostic work-up, prognostic factors and appropriate therapeutic choices for these patients. Radiotherapy is the treatment of choice for most patients with brain metastases. Surgery and whole brain radiotherapy for the treatment of single brain metastasis in patients with stable extracranial disease is at the present time the best treatment option for this particular group. Radiosurgery, treatment that is a possible replacement for surgery, is not yet established as an effective treatment. Chemotherapy is not the primary therapy for these patients. The overall prognosis for patients with brain metastases remains poor.