Current strategies in the surgical management of cerebral metastases

An evidence-based review

Timothy L. Siu*, Rosalind L. Jeffree, John W. Fuller

*Corresponding author for this work

    Research output: Contribution to journalReview article

    17 Citations (Scopus)

    Abstract

    Metastatic tumours are the most common form of cerebral neoplasm, occurring in up to 40% of patients with systemic cancer. Although the presence of metastatic disease portends limited survival, aggressive management of cerebral metastases is vital to preventing death from neurological causes and prolonging functional independence. Due to advancement in neurosurgical techniques and the advent of stereotactic radiosurgery as a non-operative alternative, current decision making for selecting the appropriate local treatment often results in clinical equipoise. In addition, the traditional blanket application of whole brain radiation has come under scrutiny as new evidence regarding the deleterious neurocognitive effects of ionizing radiation emerges. The completion of a series of randomized studies comparing the efficacy of surgery, radiosurgery, whole brain radiotherapy and various combined approaches for cerebral metastases in recent years has shed important light on addressing some of these issues. The focus of this review is to summarize the key findings and outline a practical approach for the management of cerebral metastases.

    Original languageEnglish
    Pages (from-to)1429-1434
    Number of pages6
    JournalJournal of Clinical Neuroscience
    Volume18
    Issue number11
    DOIs
    Publication statusPublished - Nov 2011

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