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Metastasi cerebrali

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Le complicazioni neurologiche in oncologia

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Nei pazienti affetti da neoplasia sistemica solida, le localizzazioni metastastiche sono la seconda causa di disfunzione cerebrale dopo l’encefalopatia metabolica. Le casistiche pubblicate sulle metastasi cerebrali (BM) mostrano notevoli differenze [1]. Gli studi epidemiologici basati sui certificati di morte, sulle cartelle cliniche ospedaliere e sui registri dei tumori, considerati singolarmente o in combinazione, sottostimano l’incidenza delle metastasi intracraniche spesso anche sintomatiche, mentre gli studi autoptici indicano che le BM sono complicanze assai frequenti [2–4]. Circa il 20–40% dei pazienti deceduti per neoplasia presenta metastasi intracraniche, nel 15–20% è coinvolto il parenchima cerebrale che rappresenta l’unica localizzazione metastatica intracranica nel 10% dei casi.

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Bibliografia

  1. Walker AE, Robins M, Weinfeld FD (1985) Epidemiology of brain tumors: The national survey of intracranial neoplasms. Neurology 35:219–226

    PubMed  CAS  Google Scholar 

  2. Posner JB (1992) Management of brain metastases. Rev Neurol 148:477–487

    PubMed  CAS  Google Scholar 

  3. Posner JB (1996) Brain metastases: 1995. A brief review. J NeuroOncol 27:287–293

    Article  PubMed  CAS  Google Scholar 

  4. Jemal A, Tiwar R, Murray T et al (2004) Cancer Statistics, 2004. CA Cancer J Clin 54:8–29

    PubMed  Google Scholar 

  5. Hildebrand J (1978) Lesions of the nervous system in cancer patients. Raven Press, New York

    Google Scholar 

  6. Posner JB (1980) Brain metastases: a clinician’s view. In: Weiss L, Gilbert HA, Posner JB (eds) Brain Metastases. Hall, Boston, pp 2–29

    Google Scholar 

  7. Riva M, Brioschi A (1995) Le complicanze neurologiche delle neoplasie sistemiche. In: Sterzi R, Riva M (eds) Le complicanze neurologiche in medicina generale. Edifarm, Milano, pp 159–176

    Google Scholar 

  8. Patchell RA (1991) Brain Metastases. Neurol Clin 9:817–824

    PubMed  CAS  Google Scholar 

  9. Percy AK Elveback LR, Okazaki H, Kurland LT (1972) Neoplasms of the central nervous system. Epidemiologic considerations. Neurology 22:40–48

    PubMed  CAS  Google Scholar 

  10. Rosenblatt J (1973) Diagnostic accuracy in cancer as determined by post-mortem examination. Prog Clin Cancer 5:71–80

    PubMed  CAS  Google Scholar 

  11. Chason JL, Walkers FB, Landers JW (1963) Metastatic carcinoma in the central nervous system and dorsal root ganglia. A prospective autopsy study. Cancer 16:781–787

    Article  PubMed  CAS  Google Scholar 

  12. Tsukada Y, Fouad A, Pickren JW, Lane WW. (1983) Central nervous system metastasis from breast carcinoma. Autopsy study. Cancer 52:2349–2354

    Article  PubMed  CAS  Google Scholar 

  13. Delattre JY, Krol G, Thaler HT, Posner JB (1988) Distribution of brain metastases. Arch Neurol 45:741–744

    PubMed  CAS  Google Scholar 

  14. Nussbaum ES, Djalilian HR, Cho KH, Hall WA (1996) Brain metastases. Histology, multiplicity, surgery, and survival. Cancer 78:1781–1788

    Article  PubMed  CAS  Google Scholar 

  15. Boogerd W, Vos VW, Hart AA, Baris G (1993) Brain metastases in breast cancer; natural history, prognostic factors and outcome. J Neurooncol 15:165–174

    Article  PubMed  CAS  Google Scholar 

  16. Sampson JH, Carter JH Jr, Friedman AH, Seigler HF (1998) Demographics, prognosis, and therapy in 702 patients with brain metastases from malignant melanoma. J Neurosurg 88:11–20

    PubMed  CAS  Google Scholar 

  17. Merchut MP (1989) Brain metastases from undiagnosed systemic neoplasms. Arch Intern Med 149:1076–1080

    Article  PubMed  CAS  Google Scholar 

  18. Debevec M (1990) Management of patients with brain metastases of unknown origin. Neoplasma 37:601–606

    PubMed  CAS  Google Scholar 

  19. Nguyen LN, Maor MH, Oswald MJ (1998) Brain metastases as the only manifestation of an undetected primary tumor. Cancer 83:2181–2184

    Article  PubMed  CAS  Google Scholar 

  20. Ruderman NB, Hall TC (1965) Use of glucocorticoids in the palliative treatment of metastatic brain tumors. Cancer 18:298–306

    Article  PubMed  CAS  Google Scholar 

  21. Horton J, Baxter DH, Olson KB (1971) The management of metastases to the brain by irradiation and corticosteroids. Am J Roentgenol Radium Ther Nucl Med 111:334–336

    PubMed  CAS  Google Scholar 

  22. Markesbery WR, Brooks WH, Gupta GD, Young AB (1978) Treatment for patients with cerebral metastases. Arch Neurol 35:754–756

    PubMed  CAS  Google Scholar 

  23. Agboola O, Benoit B, Cross P et al (1998) Prognostic factors derived from recursive partition analysis (RPA) of Radiation Therapy Oncology Group (RTOG) brain metastases trials applied to surgically resected and irradiated brain metastatic cases. Int J Radiat Oncol Biol Phys 42:155–159

    Article  PubMed  CAS  Google Scholar 

  24. Jeremic B, Becker G, Plasswilm L, Bamberg M (2000) Activity of extracranial metastases as a prognostic factor influencing survival after radiosurgery of brain metastases. J Cancer Res Clin Oncol 126:475–480

    Article  PubMed  CAS  Google Scholar 

  25. Potts DG, Abbott GF, von Sneidern JV (1980) National Cancer Institute Study: evaluation of computed tomography in the diagnosis on intracranial neplasms. III. Metastatic tumors. Radiology 136:657–664

    PubMed  CAS  Google Scholar 

  26. Egelhoff JC, Ross JS, Modic MT et al (1992) MR imaging of metastases GI adenocarcinoma in brain. Am J Neuroradiol 13:1221–1224

    PubMed  CAS  Google Scholar 

  27. Hwang T-L, Valdivieso JG, Yang CH, Wolin MJ (1993) Calcified brain metastasis. Neurosurgery 32:451–454

    Article  PubMed  CAS  Google Scholar 

  28. Destian S, Sze G, Krol G et al (1989) MR imaging of hemorrhagic intracranial neoplasms. AJR Am J Roentgenol 152:137–144

    PubMed  CAS  Google Scholar 

  29. Atlas SW, Grossman RI, Gomori JM et al (1987) MR imaging of intracranial metastatic melanoma. J Comput Assist Tomogr 11:577–582

    Article  PubMed  CAS  Google Scholar 

  30. Sze G, Shin J, Krol G et al (1988) Intraparenchymal brain metastases: MR imaging versus contrast-enhanced CT. Radiology 168:187–194

    PubMed  CAS  Google Scholar 

  31. Sze G, Milano E, Johnson C, Heier L (1990) Detection of brain metastases: comparison of contrast-enhanced MR with unenhanced MR and enhanced CT. AJNR Am J Neuroradiol 11:785–791

    PubMed  CAS  Google Scholar 

  32. Riva M, Landonio G, Arena O et al (2001) Pathophysiology, clinical manifestations and supportive care of metastatic brain cancer. Forum (Genova) 11:4–25

    PubMed  CAS  Google Scholar 

  33. Dhopesh VP, Yagnik PM (1985) Brain Metastasis: analysis of patients without known cancer. South Med J 78:171–172

    PubMed  CAS  Google Scholar 

  34. Zimm S, Wampler GL, Stablein D et al (1981) Intracerebral metastases in solid-tumor patients: natural history and results of treatment. Cancer 48:384–394

    Article  PubMed  CAS  Google Scholar 

  35. Patchell RA, Tibbs PA, Walsh JW et al (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322:494–500

    Article  PubMed  CAS  Google Scholar 

  36. Vecht CJ, Haaxma-Reiche H, Noordijk EM et al (1993) Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery? Ann Neurol 33:583–590

    Article  PubMed  CAS  Google Scholar 

  37. Bindal RK, Sawaya R, Leavens ME, Lee JJ (1993) Surgical treatment of multiple brain metastases. J Neurosurg 79:210–216

    PubMed  CAS  Google Scholar 

  38. Bindal RK, Sawaya R, Leavens ME et al (1995) Reoperation for recurrent metastatic brain tumors. J Neurosurg 83:600–604

    PubMed  CAS  Google Scholar 

  39. Pieper DR, Hess KR, Sawaya RE (1997) Role of surgery in the treatment of brain metastases in patients with breast cancer. Ann Surg Oncol 4:481–490

    Article  PubMed  CAS  Google Scholar 

  40. Rottenberg DA, Chernik NL, Deck MD, Ellis F, Posner JB (1977) Cerebral necrosis following radiotherapy of external neoplasm. Ann Neurol 1:339–357

    Article  PubMed  CAS  Google Scholar 

  41. Sundaresan N, Galicich JH, Deck MD, Tomita T (1981) Radiation necrosis after treatment of solitary intracranial metastases. Neurosurgery 8:329–333

    Article  PubMed  CAS  Google Scholar 

  42. DeAngelis LM, Delattre JY, Posner JB (1989) Radiation-induced dementia in patients cured of brain metastases. Neurology 39:789–796

    PubMed  CAS  Google Scholar 

  43. Dropcho EJ (1991) Central nervous system injury by therapeutic irradiation. Neurol Clin 9:969–988

    PubMed  CAS  Google Scholar 

  44. Patchell RA, Tibbs PA, Regine WF et al (1998) Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 280:1485–1489

    Article  PubMed  CAS  Google Scholar 

  45. Patchell RA, Cirrincione C, Thaler HT et al (1986) Single brain metastases: surgery plus radiation or radiation alone. Neurology 36:447–453

    PubMed  CAS  Google Scholar 

  46. DeAngelis LM, Mandell LR, Thaler HT et al (1989) The role of postoperative radiotherapy after resection of single brain metastases. Neurosurgery 24:798–805

    Article  PubMed  CAS  Google Scholar 

  47. Dosoretz DE, Blitzer PH, Russell AH, Wang CC (1980) Management of solitary metastasis to the brain: the role of elective brain irradiation following complete surgical resection. Int J Radiat Oncol Biol Phys 6:1727–1730

    PubMed  CAS  Google Scholar 

  48. Smalley SR, Laws ER Jr, O’Fallon JR et al (1992) Resection for solitary brain metastasis: role of adjuvant radiation and prognostic variables in 229 patients. J Neurosurg 77:531–540

    Article  PubMed  CAS  Google Scholar 

  49. Soffietti R, Ruda R, Mutani R (2002) Management of brain metastases. J Neurol 249:1357–1369

    Article  PubMed  Google Scholar 

  50. Petrovich Z, Yu C, Giannotta SL et al (2002) Survival and pattern of failure in brain metastasis treated with stereotactic gamma knife radiosurgery. J Neurosurg 97:499–506

    PubMed  Google Scholar 

  51. Becker G, Jeremic B, Engel C et al (2002) Radiosurgery for brain metastases: the Tuebingen experience. Radiother Oncol 62:233–237

    Article  PubMed  Google Scholar 

  52. Li B, Yu J, Suntharalingam M, Kennedy AS et al (2000) Comparison of three treatment options for single brain metastasis from lung cancer. Int J Cancer 90:37–45

    Article  PubMed  CAS  Google Scholar 

  53. Huang CF, Kondziolka D, Flickinger JC, Lunsford LD (1999) Stereotactic radiosurgery for brainstem metastases. J Neurosurgery 91:563–568

    Article  CAS  Google Scholar 

  54. Muacevic A, Kreth FW, Horstmann GA et al (1999) Surgery and radiotherapy compared with gamma knife radiosurgery in the treatment of solitari cerebral metastases of small diameter. J Neurosurg 91:35–43

    PubMed  CAS  Google Scholar 

  55. Chen JC, Petrovich Z, O’Day S et al (2000) Stereotactic radiosurgery in the treatment of metastatic disease to the brain. Neurosurgery 47:268–279

    Article  PubMed  CAS  Google Scholar 

  56. Mehta M, Noyes W, Craig B et al (1997) A cost-effectiveness and cost-utility analysis of radiosurgery versus resection for single-brain metastases. Int J Radiat Oncol Biol Phys 39:445–454

    Article  PubMed  CAS  Google Scholar 

  57. Weltman E, Salvajoli JV, Brandt RA et al (2001) Radiosurgery for brain metastases: who may not benefit? Int J Radiat Oncol Biol Phys 51:1320–1327

    Article  PubMed  CAS  Google Scholar 

  58. Lavine SD, Petrovich Z, Cohen-Gadol AA et al (1999) Gamma knife radiosurgery for metastatic melanoma: an analysis of survival, outcome, and complications. Neurosurgery 44:59–64

    Article  PubMed  CAS  Google Scholar 

  59. Brown PD, Brown CA, Pollock BE et al (2002) Stereotactic radiosurgery for patients with “radioresistant” brain metastases. Neurosurgery 51:656–665

    Article  PubMed  Google Scholar 

  60. Chen JC, Petrovich Z, Giannotta SL et al (2000) Radiosurgical salvage therapy for patients presenting with recurrence of metastatic disease to the brain. Neurosurgery 46:860–866

    Article  PubMed  CAS  Google Scholar 

  61. Shaw E, Scott C, Souhami L et al (2000) Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain meta-stases: final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys 47:291–298

    Article  PubMed  CAS  Google Scholar 

  62. Alexander E 3rd, Moriarty TM, Davis RB et al (1995) Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases. J Natl Cancer Inst 87:34–40

    Article  PubMed  Google Scholar 

  63. Schoeggl A, Kitz K, Ertl A et al (1999) Prognostic factor analysis for multiple brain metastases after g-knife radiosurgery: results in 97 patients. J Neurooncol 42:169–175

    Article  PubMed  CAS  Google Scholar 

  64. Greig N (1987) Optimizing drug delivery to brain tumour. Cancer Treat Rev 14:1–28

    Article  PubMed  CAS  Google Scholar 

  65. Tanaka E (1999) Clinically significant pharmacokinetic drug interactions between antiepileptic drugs. J Clin Pharm Ther 24:87–92

    Article  PubMed  CAS  Google Scholar 

  66. Riva M, Landonio G, Defanti CA, Siena S (2000) The effect of anticonvulsants drugs on blood levels of methotrexate. J Neurooncol 48:249–250

    Article  PubMed  CAS  Google Scholar 

  67. Ryan GF, Ball DL, Smith JG (1995) Treatment of brain metastases from primary lung cancer. Int J Radiat Oncol Biol Phys 31:273–278

    Article  PubMed  CAS  Google Scholar 

  68. Boogerd W, Dalesio O, Bais EM, van der Sande JJ (1992) Response of brain metastases from breast cancer to systemic chemotherapy. Cancer 69:972–980

    Article  PubMed  CAS  Google Scholar 

  69. Cloughesy TF, Black KL (1995) Pharmacological blood-brain barrier modification for selective drug delivery. J Neurooncol 26:125–132

    Article  PubMed  CAS  Google Scholar 

  70. Zlokovic BV, Apuzzo MLJ (1998) Strategies to circumvent vascular barriers of the central nervous system. Neurosurgery 43:877–878

    Article  PubMed  CAS  Google Scholar 

  71. Moscow JA, Cowan KH (1988) Multidrug resistance. J Natl Cancer Inst 80:14–20

    Article  PubMed  CAS  Google Scholar 

  72. Ford JM, Hait WN (1990) Pharmacology of drugs that alter multidrug resistance in cancer. Pharmacol Rev 42:155–199

    PubMed  CAS  Google Scholar 

  73. Mac Donald D (1997) Neurotoxicity of chemotherapeutic agents. In Perry M (ed) The Chemotherapy Source Book. Williams & Wilkins, Baltimore, pp 755–765

    Google Scholar 

  74. Cushing H (1932) The basophil adenomas of the pituitary body and their clinical manifestations. Johns Hopkins Med J 50:137–195

    Google Scholar 

  75. Muller R, Kugelberg E (1959) Myopathy in Cushing’s syndrome. J Neurol Neurosurg Psychiatry 27:314–321

    Article  Google Scholar 

  76. Wen PY (1997) Diagnosis and management of brain tumors. In Black PM, Loeffler JS (eds) Cancer of the Nervous System. Blackwell Scientific, London, pp 106–127

    Google Scholar 

  77. Dropcho EJ, Soong SJ (1991) Steroid-induced weakness in patients with primary brain tumors. Neurology 41:1235–1239

    PubMed  CAS  Google Scholar 

  78. Batchelor TT, Taylor LP, Thaler HT et al (1997) Steroid myopathy in cancer patients. Neurology 48:1234–1238

    PubMed  CAS  Google Scholar 

  79. Vecht CJ, Hovestadt A, Verbiest HB et al (1994) Dose-effect relationship of dexamethasone on Karnofsky performance in metastatic brain tumors: a randomized study of 4, 8 and 16 mg per day. Neurology 44:675–680

    PubMed  CAS  Google Scholar 

  80. Cairncross JG, MacDonald DR, Pexman JH, Ives FJ (1988) Steroid-induced CT changes in patients with recurrent malignant glioma. Neurology 38:724–726

    PubMed  CAS  Google Scholar 

  81. Holodny AI, Nusbaum AO, Festa S et al (1999) Correlation between the degree of contrast enhancement and the volume of peritumoral edema in meningiomas and malignant gliomas. Neuroradiology 41:820–825

    Article  PubMed  CAS  Google Scholar 

  82. Perry JR, DeAngelis L, Schold SC Jr et al (1997) Challenges in the design and conduct of phase III brain tumor therapy trials. Neurology 49:912–917

    PubMed  CAS  Google Scholar 

  83. Jackson JH (1882) Localised convulsions from tumour of the brain. Brain 5:364–374

    Article  Google Scholar 

  84. Penfield W, Erickson TC, Tarlov I (1940) Relation of intracranial tumours and symptomatic epilepsy. Arch Neurol Psychiatry 44:300–315

    Google Scholar 

  85. Macleod M, Slattery J, Grant R. (1995) The effect of tumour associated epilepsy on performance/handicap scales used in cerebral glioma. Brit J Neurosurg 9:653–657

    Article  CAS  Google Scholar 

  86. Delattre J, Safai B, Posner JB (1988) Erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and phenytoin. Neurology 38:194–198

    PubMed  CAS  Google Scholar 

  87. Glantz MJ, Cole BF, Friedberg MH et al (1996) A randomized, blinded, placebo-controlled trial of divalproex sodium prophylaxis in adult with newly diagnosed brain tumors. Neurology 46:985–991

    PubMed  CAS  Google Scholar 

  88. Villemure JG, de Tribolet N (1996) Epilepsy in patients with central nervous system tumors. Curr Opin Neurol 9:424–428

    Article  PubMed  CAS  Google Scholar 

  89. Glantz MJ, Cole BF, Forsyth PA et al (2000) Practice parameter: Anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Neurology 54:1886–1893

    PubMed  CAS  Google Scholar 

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  1. U.O. Neurologia, Ospedale Niguarda Ca’Granda, Milano

    Maurizio Riva

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Riva, M. (2006). Metastasi cerebrali. In: Le complicazioni neurologiche in oncologia. Springer, Milano. https://doi.org/10.1007/978-88-470-0440-5_3

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