Treatment strategies in CNS metastases

CNS metastases constitute the most common brain malignancy in adults and, therefore, represent a challenging issue in cancer treatment.

To review the role and indication of the various treatment options in the context of important prognostic factors that may guide the selection of patients who could benefit from each treatment modality.

Therapeutic approaches in treating CNS metastases include surgery, radiotherapy and systemic chemotherapy, and are reviewed through a critical evaluation of published recent literature; however, in the majority of most common malignancies spreading to the CNS, treatment remains largely palliative and rarely curative, as is the case for other metastastic sites.

It is anticipated that a multidisciplinary approach with rapid integration of new treatment strategies is required for the treatment of patients developing CNS metastases, ultimately aiming to prolong survival, preserve neurologic function and improve quality of life.