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WBRT may be administered in combination with stereotactic radiosurgery (SRS), surgery, or systemic therapies. [1] While these can improve survival for some patients with single brain metastasis, a 2021 systematic review of the literature found inconsistent results for overall survival. [1]
For brain metastases, these treatment options include whole brain radiation therapy (WBRT), surgery, and systemic therapies. However, a recent systematic review found no difference in the affects on overall survival or deaths due to brain metastases when comparing SRS treatment alone to SRS plus WBRT treatment or WBRT alone. [27]
Treatment for brain metastases is primarily palliative, with the goals of therapy being reduction of symptoms and prolongation of life. However, brain metastases harboring a mutation in the BRAF kinase at position V600 are effectively druggable with small molecule inhibitors such as dabrafenib.
People who receive stereotactic radiosurgery (SRS) and whole-brain radiation therapy (WBRT) for the treatment of metastatic brain tumors have more than twice the risk of developing learning and memory problems than those treated with SRS alone.
Diagnostic techniques for CNS metastasis are a major area of ongoing research, as detecting metastatic lesions early is crucial for timely treatment and better patient outcomes. [ 14 ] One promising field is the use of biomarkers - proteins, genes, or other molecules associated with a specific condition.
Stereotactic surgery is a minimally invasive form of surgical intervention that makes use of a three-dimensional coordinate system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation, radiosurgery (SRS), etc.
This is a concern during treatment of brain tumors and brain metastases, especially where there is pre-existing raised intracranial pressure or where the tumor is causing near-total obstruction of a lumen (e.g., trachea or main bronchus). Surgical intervention may be considered prior to treatment with radiation.
However, when radiotherapy is used, whole brain or involved-field treatment is given. This method utilizes a standard fractionation schedule and a total tumor dose of 50-55 Gy. [ 5 ] Gamma knife surgery is a form of radiotherapy, more specifically radiosurgery that uses beams of gamma rays to deliver a certain dosage of radiation to the tumor.
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