Cerebral metastases remain a common complication among patients with cancer. Historically, whole-brain radiotherapy has remained the standard of care, with surgery being reserved for selected cases. Recent advances have changed our practice, however. In particular, stereotactic radiosurgery has emerged as a vital treatment modality for this disease. In addition, chemotherapy, including temozolomide, topoisomerase inhibitors and antimetabolites, and treatment sensitizers, such as efaproxiral and motexafin gadolinium, are actively being assessed in clinical trials, and are likely to play an increasing role in the management of cerebral metastases in the future. Nonetheless, many uncertainties remain, such as the optimal combination and timing of therapeutics. As the arsenal of therapeutics expands, it will be increasingly important to select appropriate patients for a particular treatment paradigm. Understanding the efficacy and toxicity of treatment is essential to this task.

译文

脑转移仍然是癌症患者的常见并发症。从历史上看,全脑放疗一直是护理的标准,手术是为选定的病例保留的。然而,最近的进展改变了我们的做法。特别是,立体定向放射外科已成为该疾病的重要治疗方式。此外,化疗,包括替莫唑胺、拓扑异构酶抑制剂和抗代谢物,以及治疗敏化剂,如efaproxiral和motexafin钆,正在临床试验中积极评估,并可能在未来脑转移的管理中发挥越来越大的作用。尽管如此,仍然存在许多不确定性,例如治疗的最佳组合和时机。随着治疗学库的扩展,为特定的治疗范例选择合适的患者将变得越来越重要。了解治疗的疗效和毒性对于这项任务至关重要。

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