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Related Concept Videos

Metastasis02:30

Metastasis

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Metastasis is the spread of cancer cells from the original site to distant locations in the body. Cancer cells can spread via blood vessels (hematogenous) as well as lymph vessels in the body.
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...
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Related Experiment Video

Updated: Oct 15, 2025

Minimally Invasive Cisterna Magna Injection Model for Leptomeningeal Metastasis Studies in Mice
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Minimally Invasive Cisterna Magna Injection Model for Leptomeningeal Metastasis Studies in Mice

Published on: May 23, 2025

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Central Nervous System Metastases.

Edwin Nieblas-Bedolla1, Jeffrey Zuccato2, Harriet Kluger3

  • 1Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.

Hematology/Oncology Clinics of North America
|October 29, 2021
PubMed
Summary

Central nervous system (CNS) metastases are rising, often detected late. Treatment involves surgery, radiation, and increasing use of systemic therapies for better patient outcomes.

Keywords:
Brain metastasesCentral nervous systemSpinal metastasesSystemic cancer

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Area of Science:

  • Neuro-oncology
  • Neurosurgery
  • Radiation Oncology

Background:

  • Increasing incidence of central nervous system (CNS) metastases.
  • Late detection of CNS metastases, often upon symptom onset.
  • Need for diverse treatment strategies for brain and spinal metastases.

Purpose of the Study:

  • To outline current therapeutic approaches for CNS metastases.
  • To detail surgical, radiosurgical, and radiotherapeutic interventions.
  • To highlight the growing role of systemic therapies.

Main Methods:

  • Review of indications for surgical resection (solitary/symptomatic brain metastases, spinal lesions).
  • Description of stereotactic radiosurgery for limited brain and spinal metastases.
  • Explanation of radiotherapy techniques (whole-brain, external beam) and their applications.
  • Mention of surgical biopsies for histological diagnosis.
  • Acknowledgement of systemic therapy's expanding role.

Main Results:

  • Surgical interventions are tailored to metastasis type and stability (resection, separation, instrumentation).
  • Radiosurgery and radiotherapy offer targeted or broad treatment options based on metastasis characteristics.
  • Biopsies are crucial for definitive diagnosis when needed.
  • Systemic therapies are becoming a more integrated part of CNS metastasis management.

Conclusions:

  • A multimodal approach combining surgery, radiation, and systemic therapy is essential for managing CNS metastases.
  • Treatment selection depends on metastasis location, size, radiosensitivity, and patient condition.
  • Early detection and timely intervention remain critical for improving prognoses in CNS metastasis patients.