ABSTRACT
This chapter reviews the treatment options for patients with brain metastases while focusing on recent advances. A vital task in approaching a patient with brain metastases is assessing neurologic stability. Future directions in the medical management of brain metastases include the development of new agents with less toxicity than the standard approach of anticonvulsants and steroids. The use of radiotherapy in the treatment of brain metastases includes whole brain radiation therapy, either as definitive treatment or as adjuvant to surgical resection or radiosurgery, and radiosurgery. Stereotactic radiosurgery is a technique that delivers precise, conformal radiation to a defined target in a single large dose. It is able to deliver a high dose of radiation to the lesion while sparing the maximum amount of normal tissue. Neurocognitive dysfunction may be caused by the tumor, radiotherapy, surgery, systemic treatment such as chemotherapy and endocrine therapy, and adjuvant medications. Neurocognitive function has become an increasingly important issue for patients with prolonged survival.
