Onkológia 5/2013

Palliative radiotherapy – brain metastatic disease

Brain metastases are a serious medical problem affecting 20-40% of cancer patients. The goal of treatment of brain metastatic disease is to achieve local control with low risk of distant brain relapses. Main therapeutical approaches are neurosurgical extirpation and irradiation. Radiation therapy could be applied as whole brain radiotherapy (WBRT) or focal irradiation of metastatic lesions with stereotactic radiosurgery (SRS) or partial brain irradiation with intensity modulated radiotherapy (IMRT) or fractionated stereotactic radiotherapy (fSRT). Due to the limited permeability of brain blood barrier for cytostatics, the role of systemic therapy is not clearly established. This article is an overview of application of individual treatment modalities and their useful combinations.

Keywords: brain metastases, neurosurgical extirpation, whole brain radiotherapy, stereotactic radiosurgery, fractionated stereotactic radiotherapy, chemotherapy.