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Modeling Brain Metastasis by Internal Carotid Artery Injection of Cancer Cells
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A multidisciplinary management algorithm for brain metastases.

Alexander Ramos1, Alexandra Giantini-Larsen1, Susan C Pannullo1

  • 1Department of Neurological Surgery, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, USA.

Neuro-Oncology Advances
|December 19, 2022
PubMed
Summary
This summary is machine-generated.

Brain metastases management is challenging, especially with multiple lesions. A new algorithm suggests omitting whole-brain radiation therapy for most patients, improving treatment strategies.

Keywords:
brain metastasesoligometastaticprecision medicinestereotactic radiosurgerywhole-brain radiation therapy

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Area of Science:

  • Neuro-oncology
  • Radiation Oncology
  • Medical Oncology

Background:

  • Brain metastases incidence remains a clinical challenge.
  • Management of multiple brain lesions is complex.
  • Advances in systemic therapy improve survival but complicate local treatment.

Purpose of the Study:

  • To review evidence for brain metastases management.
  • To propose a multidisciplinary management algorithm.
  • To incorporate precision medicine into treatment strategies.

Main Methods:

  • Review of current literature on brain metastases.
  • Development of a multidisciplinary treatment algorithm.
  • Integration of surgery, radiation, and systemic therapies.
  • Consideration of precision medicine-guided treatments.

Main Results:

  • Oligometastatic disease (1-4 lesions) is manageable with current techniques.
  • Multiple brain metastases pose significant management challenges.
  • Whole-brain radiation therapy (WBRT) may be avoidable upfront for many patients.

Conclusions:

  • A multidisciplinary approach is crucial for optimal brain metastases care.
  • Precision medicine should guide treatment selection.
  • Whole-brain radiation therapy can likely be omitted in most patients as initial therapy.