Brain Metastases

Part of the Medical Radiology book series (MEDRAD)


In many patients with brain metastases, the primary therapeutic aim is to accomplish symptom palliation and maintenance of neurologic function, but in a small selected cohort, long-term survival, and even cure, is possible. Central nervous system failures might develop after initial treatment, either locally (regrowth of a previously treated lesion), regionally (elsewhere, in the brain parenchyma), or even in the form of leptomeningeal dissemination, the latter carrying the worst prognosis. Some of these failures will not require local therapy because they develop in the terminal phase of general cancer progression, where active brain metastases treatment is neither expected to prolong survival nor improve the patient’s quality of life. At the other end of the spectrum, patients with limited brain-only relapse require effective intracranial disease control as a prerequisite for extended survival. This chapter reviews reirradiation with radioactive implants, stereotactic radiosurgery, fractionated stereotactic radiotherapy, and whole-brain radiotherapy and provides several illustrative examples.


Brain Metastasis Karnofsky Performance Status Radiation Therapy Oncology Group Recursive Partitioning Analysis Biologically Effective Dose 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • Carsten Nieder
    • 1
  • Anca L. Grosu
    • 2
  • Minesh P. Mehta
    • 3
  1. 1.Department of Oncology and Palliative MedicineNordland HospitalBodøNorway
  2. 2.Department of Radiation OncologyUniversity Hospital FreiburgFreiburgGermany
  3. 3.Department of Radiation OncologyThe Robert H. Lurie Comprehensive Cancer Center of Northwestern UniversityChicagoUSA

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