[Cerebral metastases]

Improvement of diagnosis techniques and cancer treatment efficacy explain in part the increasing incidence of brain metastasis, observed in 20 to 30 % of cancer patients. New techniques of MRI improve its sensibility and guide therapeutic decision, in conjunction with prognostic factors including age, Karnovsky performance score and control of the general disease. Surgical excision is mainly indicated for single metastasis in none functional area, or in case of mass effect, while radiosurgery represents an alternative non invasive technique, particularly for single small lesions. In other cases, whole brain radiation therapy remains the treatment of choice for brain metastasis, while no clear data support it use complementary to surgery. Chemotherapy has no proven efficacy as part of first line treatment of patients with brain metastasis and still warren further research.