Treatment of melanoma metastases in the brain

Semin Surg Oncol. 1996 Nov-Dec;12(6):429-35. doi: 10.1002/(SICI)1098-2388(199611/12)12:6<429::AID-SSU8>3.0.CO;2-C.

Abstract

Melanoma is prone to spread to the brain and is the third most common source of intracranial metastasis. Patients usually present with signs and symptoms of increased intracranial pressure, a new focal neurologic deficit, or seizures. Contrasted magnetic resonance imaging (MRI) is the single most valuable imaging modality. Surgical therapy is the appropriate choice for single lesions that are accessible, especially if they are causing significant mass effect or are located in the posterior fossa. Patients with several intracranial metastases who undergo resection of all lesions may have a similar prognosis to those with single resected lesion. Stereotactic radiosurgery appears to provide good local control of small lesions. External beam radiotherapy may provide some benefit to patients, and is often used in conjunction with surgery or stereotactic radiosurgery. To date, chemotherapy has been limited because of chemo-resistance and drug delivery issues. Future directions for treatment may include local sustained delivery of either chemotherapy or immunoregulatory molecules.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / surgery
  • Brain Neoplasms / therapy*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Melanoma / radiotherapy
  • Melanoma / secondary*
  • Melanoma / surgery
  • Melanoma / therapy*
  • Middle Aged
  • Prognosis
  • Radiosurgery
  • Radiotherapy Dosage
  • Stereotaxic Techniques
  • Tomography, X-Ray Computed

Substances

  • Antineoplastic Agents