Universität zu Köln

Ruess, Daniel, Juenger, Stephanie T., Grau, Stefan, Goldbrunner, Roland, Kocher, Martin and Ruge, Maximilian (2022). Local treatment options for limited brain metastasis. Onkologe, 28 (5). S. 405 - 411. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0415

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Abstract

Background Brain metastases comprising 1-4 lesions that are either operable or do not exceed a volume of about 15 ml when inoperable can be considered limited, especially if extracranial tumor manifestations are stable or can be treated effectively. Therapeutic procedures Resection with postoperative local irradiation, stereotactic radiosurgery and brachytherapy can be applied as sole or combined therapy for the treatment of limited brain metastasis. Adjuvant whole-brain irradiation should no longer be used routinely because of the risk for neurocognitive deficits. Local recurrences and distant brain metastases can be detected early by close magnetic resonance imaging (MRI)-based follow-up and can also be treated locally in most cases. Results Local control rates of 70-80% of the treated metastases at 1 year are achieved with local therapy techniques. Median survival rates are in the range of 10-12 months, with 20-30% of patients living longer than 3 years, and 5-10% living longer than 5 years. After radiosurgery, radiation necrosis may rarely occur and can be diagnosed by MRI follow-up, amino acid positron emission tomography (PET) or stereotactic biopsy. Conclusions Radiosurgery, resection with postoperative focal irradiation and brachytherapy are local procedures that effectively control limited cerebral metastasis, especially when used in combination or repeatedly, and provide prolonged survival to a substantial proportion of patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ruess, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Juenger, Stephanie T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-662882
DOI:	10.1007/s00761-022-01123-w
Journal or Publication Title:	Onkologe
Volume:	28
Number:	5
Page Range:	S. 405 - 411
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0415
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSTOPERATIVE STEREOTACTIC RADIOSURGERY; RADIOTHERAPY; DIAGNOSIS; MULTICENTER; DISCORDANCE; GUIDELINES; RESECTION; CANCER Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66288