Current multidisciplinary management of brain metastases.

Brain metastasis (BM), the most common adult brain tumor, develops in 20% to 40% of patients with late-stage cancer and traditionally are associated with a poor prognosis. The management of patients with BM has become increasingly complex because of new and emerging systemic therapies and advancements in radiation oncology and neurosurgery. Current therapies include stereotactic radiosurgery, whole-brain radiation therapy, surgical resection, laser-interstitial thermal therapy, systemic cytotoxic chemotherapy, targeted agents, and immune-checkpoint inhibitors. Determining the optimal treatment for a specific patient has become increasingly individualized, emphasizing the need for multidisciplinary discussions of patients with BM. Recognizing and addressing the sequelae of BMs and their treatment while maintaining quality of life and neurocognition is especially important because survival for patients with BMs has improved. The authors present current and emerging treatment options for patients with BM and suggest approaches for managing sequelae and disease recurrence.

Duke Scholars

Author Paul Wayne Sperduto Radiation Oncology

Author Peter Edward Fecci Neurosurgery

Author Jeffrey Melson Clarke Medicine, Medical Oncology

Author April Kelly Scott Salama Medicine, Medical Oncology

Author Justus D Adamson Radiation Oncology

Author Scott Richard Floyd Radiation Oncology

Author Joseph Kamel Salama Radiation Oncology

Author John Howard Sampson Neurosurgery

Author John P. Kirkpatrick Radiation Oncology