Brain metastases: surgery, radiosurgery and whole-brain radiation therapy

ABSTRACT

The brain is a preferred site of metastatic spread in cancer patients. Once a brain metastasis has been diagnosed, the median life expectancy is less than one year. The prognosis of patients with brain metastases predominantly depends on age and Kamofsky performance status, as well as extracranial disease activity. There is still much controversy conceming the optimum treatment for metastatic brain disease. In many patients, aggressive treatment of metastatic disease has been shown to restore neurological function and prevent further neurological manifestations. Selection of patients for aggressive treatment strategies should thus be based on objective criteria. The emphasis of this review is on currently relevant factors for diagnosis, surgery, whole-brain radiation therapy and methods of radiosurgery