How are brain metastasis treated?

Updated: Aug 01, 2018
  • Author: Victor Tse, MD, PhD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Medical treatments consist of symptomatic and systematic treatments. Medical management of metastatic diseases has mainly focused on the treatment of cerebral edema, headache, and seizure.

Other options are radiation therapy (whole brain radiation, focal beam, and stereotactic radiation therapy), chemotherapy, combined therapies, experimental therapies, and integration therapy.

Most tumors that metastasize to the brain are not chemosensitive, though small-cell lung cancer, breast cancer, and lymphoma respond to chemotherapy. In most cases, 2-3 chemotherapeutic agents are used in combination and in conjunction with whole-brain radiation therapy (WBRT).

Radiation therapy has become a mainstream therapy for brain metastasis. Radiation therapy includes WBRT and stereotactic radiosurgery.

Stereotactic radiosurgery is a more preferred treatment modality for radio-resistant lesions such as nonsmall cell lung cancer, renal cell carcinoma, and melanoma. It is also more frequently used to treat the resection cavity of brain metastasis, particularly in patients with breast metastatic disease.


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