Single Brain Metastasis.

摘要: The management of single brain metastases has evolved substantially over the last decade. advent triple-dose contrast-enhanced MRI scans improved radiologists’ capacity to resolve small tumors, and, thereby, resulted in a declining percentage classified as single. Only 25% 30% are single; absence systemic termed solitary. Randomized trials suggest that patients not imminent danger herniation best managed initially with dexamethasone 2 4 mg administered orally twice daily. routine use prophylactic anticonvulsants is discouraged. Patients refractory progressive tumor likely prove fatal within 3 6 months should receive fractionated whole radiotherapy. highly radiosensitive primary tumors such cell lung cancer, lymphoma, and germinoma also inactive or controllable cancer good performance status benefit from addition local strategies like surgery radiosurgery Although have been compared randomized controlled trial, data results similar. Consequently, for most fall size constraints (3.5 cm smaller diameter), preferred its relatively noninvasive nature. larger cystic obstructive hydrocephalus, neurologic instability despite corticosteroids treated craniotomy. Fractionated radiation following surgical radiosurgical metastasis appears decrease risk recurrent metastasis, although it shown improve survival. We recommend patients, be resistant radiotherapy at high neurotoxicity may reasonably defer use.