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Modern management of rare brain metastases in adults

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Abstract

Brain metastases (BM) represent the main cause of intracranial neoplasms in adults, while being relatively less common in children. Today, better treatment options of the primary malignancy lead to higher remission rates as well as prolonged stable clinical conditions. This may in part explain the increased incidence of BM. Morbidity and mortality rates in patients with malignancies deteriorate significantly in cases of metastatic involvement of the central nervous system. Nowadays, especially modern management using surgical, medical, and radiotherapeutic options for treatment of BM tends to improve survival rates and enhance quality of life. Nonetheless, almost all treatment options are considered as palliative. In this review, we outline current knowledge of the incidence, diagnostic facilities, and therapeutic management of rare BM, with consideration of the basic aspects of the primary malignancy.

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Abbreviations

5-FU:

5-Fluorouracil

ACNU:

1-(4-Amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride

BM:

Brain metastases

CNS:

Central nervous system

CT:

Computer tomography

CTX:

Chemotherapy

CUP:

Cancer of unknown primary

EC:

Esophageal carcinoma

EMC:

Endometrial cancer

EOC:

Epithelial ovarian cancer

FIGO:

Fédération Internationale de Gynécologie et d’Obstétrique

GC:

Gastric cancer

GIT:

Gastrointestinal tumor

HCC:

Hepatocellular carcinoma

KPS:

Karnofsky performance status

MRI:

Magnetic resonance imaging

MTX:

Methotrexate

PRC:

Prostate carcinoma

PSA:

Prostate-specific antigen

PTC:

Parathyroid carcinoma

RAI:

Radioactive iodine

RPA:

Recursive partitioning analysis

RS:

Radiosurgery

TC:

Thyroid carcinoma

WBRT:

Whole-brain radiotherapy

WHO:

World Health Organization

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The authors disclose the receipt of anything of value from a commercial entity or other party that directly affects the content of this manuscript. None of the authors have any financial interest in the methodology being advanced with the publication of this manuscript.

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Authors and Affiliations

  1. Academic Teaching Hospital Munich Bogenhausen, Department of Neurological Surgery, Technical University of Munich, Englschalkinger Str. 77, 81925, Munich, Germany

    Matthias J. Krammer, Andre Tomasino, David B. Schul, Michael P. Meier & Christianto B. Lumenta

  2. Department of Radiotherapy and Radiooncology, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany

    Sabrina T. Astner

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  1. Matthias J. Krammer
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  2. Andre Tomasino
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  3. David B. Schul
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  6. Christianto B. Lumenta
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Correspondence to Christianto B. Lumenta.

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Krammer, M.J., Tomasino, A., Schul, D.B. et al. Modern management of rare brain metastases in adults. J Neurooncol 105, 9–25 (2011). https://doi.org/10.1007/s11060-011-0613-6

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