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中的常见并发症。从历史上看,全脑放射疗法一直是护理的标准,只有部分病例可以接受手术治疗。但是,最近的进展改变了我们的做法。特别地,立体定向放射外科手术已成为该疾病的重要治疗方式。此外,包括替莫唑胺,拓扑异构酶抑制剂和抗代谢物在内的化学疗法,以及诸如依法洛昔洛和莫他沙芬g等治疗敏化剂,正在临床试验中得到积极评估,并且将来可能在治疗脑转移中发挥越来越重要的作用。尽管如此,仍然存在许多不确定因素,例如治疗方法的最佳组合和时机。随着治疗手段的扩展,选择适合特定治疗范例的合适患者将变得越来越重要。了解治疗的功效和毒性对该任务至关重要。

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