Initial Approach to the Patient with Multiple Newly Diagnosed Brain Metastases

Clara Kwon Starkweather; Bryan D Choi; Christopher Alvarez-Breckenridge; Priscilla K Brastianos; Kevin Oh; Nancy Wang; Helen Shih; Brian V Nahed

doi:10.1016/j.nec.2020.05.002

Initial Approach to the Patient with Multiple Newly Diagnosed Brain Metastases

Neurosurg Clin N Am. 2020 Oct;31(4):505-513. doi: 10.1016/j.nec.2020.05.002.

Authors

Clara Kwon Starkweather¹, Bryan D Choi¹, Christopher Alvarez-Breckenridge¹, Priscilla K Brastianos², Kevin Oh³, Nancy Wang³, Helen Shih³, Brian V Nahed⁴

Affiliations

¹ Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
² Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
³ Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
⁴ Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA. Electronic address: [email protected].

PMID: 32921347
DOI: 10.1016/j.nec.2020.05.002

Abstract

Brain metastases are the most common intracranial tumor in adults, with increasing incidence owing to prolonged survival times. Roughly half of patients diagnosed with new brain metastases have greater than 1 brain metastasis at the time of diagnosis, raising the question of how to optimize patient care with multiple brain metastases. The authors review studies relevant to the care of patients with brain metastasis, with emphasis on those relevant to the care of patients with multiple brain metastases. They discuss evolving strategies involving multiple modalities and the benefit of surgical management in patients with a large symptomatic brain metastasis.

Keywords: Brain metastasis; Multiple metastases; Neurosurgical oncology; Stereotactic radiosurgery.

Publication types

Review

MeSH terms

Brain Neoplasms / diagnosis*
Brain Neoplasms / therapy*
Drug Therapy / methods
Humans
Immunotherapy / methods
Neurosurgical Procedures / methods
Radiosurgery / methods
Treatment Outcome

Grants and funding

T32 GM007753/GM/NIGMS NIH HHS/United States