Cancer Treatment Today

How to follow a patient with brain mets after radiosurgery is becoming a more and more common question becasue treatments that control cancer in the rest of the boady are getting to be more and more effective and patients are living longer before cancer comes back in the brain or in the body. One does not want to overmonitor but also not to miss metastses when they come back. Many patietns remain disease free for many months even years after radiosurgery

Because irinotecan penetrates the brain-blood barrier and has an effect in primary brain cancer, there is some interest in using it for brain metastasis, especially for lung cancer and breast cancer. Most studies of irinotecan had been for brain mets of small(SCLC) and non-small cell lung cancer(NSMCLC) and not breast cancer and have had mixed results. One study enrolled several different cancer types and reported complete responses with irinotecan-based

Among solid tumors, small cell lung cancer(SCLC) is unusual in that it has the highest incidence of brain metastases. Several phase II trials have been reported using Temodar(TEM) for patients with brain metastases from solid tumors, including SCLC. In one study, two out of five patients with SCLC pretreated with whole brain radiation therapy showed disease stabilization with TEM. A second study explored the use of whole-brain radiation therapy with

In adults the primary tumors most likely to metastasize to the brain are located, in decreasing order, in the lung (minimum 50%), breast (15–25%), skin (melanoma) (5–20%), colon–rectum and kidney, but in general any malignant tumor is able to metastasize to the brain. The primary site is unknown in up to 15% of patients. Brain metastases are more often diagnosed in patients with known malignancy, when they present with neurological findings