Brain metastases: advances over the decades

Area of Science:

• Neuro-oncology
• Clinical Neurology

Background:

• Brain metastases present significant morbidity and mortality challenges.
• Effective management requires a focus on both survival and symptom control.

Purpose of the Study:

• To review current management strategies for brain metastases.
• To emphasize symptom management, including quality of life and neurocognition.

Main Methods:

• Systematic literature review.
• Analysis of outcomes including survival, brain control, and symptom management (quality of life, neurological function, neurocognition).

Main Results:

• Dexamethasone manages intracranial edema symptoms; anti-seizure medications are for treatment, not prophylaxis.
• Treatment options range from supportive care to whole brain radiotherapy (WBRT), radiosurgery, or surgery.
• Surgery/radiosurgery offer improved survival for single metastases compared to WBRT alone.

Conclusions:

• Brain metastasis management has evolved, with increasing importance placed on quality of life and neurocognition alongside survival and brain control.
• Future research focuses on advanced radiation techniques, targeted therapies, and neuroprotection.