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Review
. 2021 Mar;92(3):200-209.
doi: 10.1007/s00104-020-01344-y. Epub 2021 Jan 27.

[Brain metastases-Interdisciplinary approach towards a personalized treatment]

[Article in German]
S Grau  1   2 , M Herling  3   4 , C Mauch  5   4 , N Galldiks  6   4   7 , H Golla  8   4 , M Schlamann  9 , A H Scheel  10   4 , E Celik  11   4 , M Ruge  12   4 , R Goldbrunner  13   4
Affiliations
Review

[Brain metastases-Interdisciplinary approach towards a personalized treatment]

[Article in German]
S Grau et al. Chirurg. 2021 Mar.

Abstract
in English, German

The incidence, treatment and prognosis of patients with brain metastases have substantially changed during the last decades. While the survival time after diagnosis of cerebral metastases was on average a maximum of 3-6 months only 10 years ago, the survival time could be significantly improved due to novel surgical, radiotherapeutic and systemic treatment modalities. Only a few years ago, the occurrence of brain metastases led to a withdrawal from systemic oncological treatment and the exclusion of drug therapy studies and to a purely palliatively oriented treatment in the sense of whole brain radiation therapy (WBRT) with or without surgery. The increasing availability of targeted and immunomodulatory drugs as well as adapted radio-oncological procedures enable increasingly more personalized treatment approaches. The aim of this review article is to demonstrate the progress and complexity of the treatment of brain metastases in the context of modern comprehensive interdisciplinary concepts.

Die Inzidenz, Behandlung und Prognose von Patienten mit Hirnmetastasen haben sich in den letzten Jahrzehnten grundlegend geändert. Während die Überlebenszeit zerebral metastasierter Patienten noch vor 10 Jahren durchschnittlich 3 bis maximal 6 Monate betrug, konnte diese aufgrund neuer Methoden in der operativen, strahlentherapeutischen und systemischen Behandlung deutlich verlängert werden. Noch vor wenigen Jahren führte das Auftreten von Hirnmetastasen zu einem Rückzug aus der systemisch-onkologischen Behandlung und dem Ausschluss aus medikamentösen Therapiestudien und zu einer rein palliativ orientierten Behandlung im Sinne einer Ganzhirnbestrahlung (WBRT) mit oder ohne Operation. Die zunehmende Verfügbarkeit zielgerichteter und immunmodulatorischer Medikamente sowie adaptierte radioonkologischer Verfahren erlauben immer mehr individualisierte Therapieansätze. Im Rahmen dieser Übersichtsarbeit soll der Fortschritt und die Komplexität der Behandlung von Hirnmetastasen im Kontext moderner fachübergreifender Konzepte dargelegt werden.

Keywords: Brain metastases; Radiosurgery; Radiotherapy; Targeted treatment; Treatment monitoring.

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References

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