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Chemotherapy for Brain Metastasis and Quality of Life

  • R. Addeo
  • G. Cimmino
  • S. D. Prete
Reference work entry

Abstract:

Brain  metastases incidence is increasing among patients with  solid tumors. Treatment options are limited and frequently the  palliative approaches remain the standard treatment to relieve neurologic symptoms with a decrease in survival and  quality of life. Therapeutic approaches to  brain metastases include surgery,  whole brain radiotherapy (WBRT),  stereotactic radiosurgery (SRS), and  chemotherapy.

For patients with multiple brain metastases, improvement in quality of life and neuralgic function remain important objectives. In this chapter the current role of chemotherapy and the impact on the Quality of life in these patients is summarized.

 Temozolomide, an oral imidazotetrazinone methylating agent, is highly bio-available after oral administration, has excellent central nervous system penetration, and reaches the brain in therapeutic concentrations. Tolerability of this agent has been confirmed by clinical trials in patients with BM.

Several combination chemotherapy in first-line treatment for brain metastases was investigated, and in newly diagnosed brain metastases, the tumors are responsive as the primary systemic cancer, as demonstrated by several phase II studies.

The results of recent trials support the efficacy and safety of WBRT and chemotherapy in the treatment of patients with BM from a variety of solid tumors. The data show that this choice can also offer significant palliation for BM, improving global Quality of Life.

Keywords

Brain Metastasis Human Epidermal Growth Factor Receptor Neurocognitive Function Multiple Brain Metastasis Diagnose Brain Metastasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

BBB

 blood brain barrier

BM

brain metastases

CNS

central nervous system

CR

complete response

EGFR

epidermal growth factor receptor

FACT

functional assessment of cancer therapy

5-FU

5-fluoruracil

KPS

Karnofsky performance status

MRI

magnetic resonance imaging

NSCLC

non small cell lung cancer

PR

partial response

QOL

quality of life

RPA

recursive partitioning analysis

RTOG

radiation therapy oncology group

SRS

stereotactic radiosurgery

TMZ

temozolomide

WBRT

whole brain radiotherapy

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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • R. Addeo
  • G. Cimmino
  • S. D. Prete

There are no affiliations available

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