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Updated: Aug 21, 2026
Modeling Brain Metastasis by Internal Carotid Artery Injection of Cancer Cells
Published on: August 2, 2022
Treatment of brain metastases in uncommon tumors
Alicia Tosoni1, Franco Lumachi, Alba A Brandes
1Department of Medical Oncology, Azienda Ospedale, University of Padova, Italy. alicia.tosoni@unipd.it
Abstract:
Melanoma spreads to the CNS with an incidence of 4 to 20%. Metastases from cancer of the colorectal and genitourinary tract, as well as sarcoma, are less frequent (1%). Surgery should be considered for single brain metastases in patients with controllable disease. Stereotactic needle biopsy may still be worthwhile to confirm diagnosis, and also in patients whose tumors are considered unresectable. Whole-brain radiotherapy is the treatment of choice for most brain metastases, since more than 70% of patients have multiple metastases at the time of diagnosis. Radiosurgery is particularly useful for patients unable to tolerate surgery and for patients with lesions inaccessible to surgery. Chemotherapy could be useful in patients with asymptomatic brain metastases and uncontrolled extracranial disease, depending on performance status and previous chemotherapy received.
Insights
Melanoma frequently spreads to the central nervous system (CNS). Treatment options for brain metastases include surgery, whole-brain radiotherapy, radiosurgery, and chemotherapy, chosen based on disease extent and patient factors.
Area of Science:
- Neuro-oncology
- Medical oncology
Background:
- Brain metastases are a significant complication of systemic cancers.
- Melanoma is a common primary source of CNS metastases, occurring in 4-20% of patients.
- Other cancers like colorectal, genitourinary, and sarcomas less frequently metastasize to the CNS (1%).
Purpose of the Study:
- To review the incidence and management strategies for brain metastases.
- To outline current treatment modalities for CNS metastases from various primary cancers.
Main Methods:
- Literature review of studies on brain metastases.
- Analysis of treatment outcomes for different therapeutic approaches.
Main Results:
- Surgery is recommended for single brain metastases in patients with controlled systemic disease.
- Stereotactic needle biopsy can be valuable for diagnosis, especially for unresectable tumors.
- Whole-brain radiotherapy is the primary treatment for most patients, particularly those with multiple metastases (over 70%).
- Radiosurgery offers an alternative for surgical candidates or unresectable lesions.
- Chemotherapy may benefit asymptomatic patients with uncontrolled extracranial disease, considering performance status and prior treatments.
Conclusions:
- Management of brain metastases requires a tailored approach based on primary cancer type, number and location of lesions, and patient condition.
- Multidisciplinary treatment strategies, including surgery, radiotherapy, and chemotherapy, are crucial for improving outcomes in patients with CNS metastases.
