The evolving role of neurosurgery for ...
Document type :
Article dans une revue scientifique: Article de synthèse/Review paper
PMID :
Permalink :
Title :
The evolving role of neurosurgery for central nervous system metastases in the era of personalized cancer therapy
Author(s) :
Karschnia, Philipp [Auteur]
Le Rhun, Emilie [Auteur]
309388|||University hospital of Zurich [Zurich]
Vogelbaum, Michael A. [Auteur]
University of South Florida [Tampa] [USF]
Van Den Bent, Martin J. [Auteur]
Erasmus University Medical Center [Rotterdam] [Erasmus MC]
Grau, Stefan J. [Auteur]
Preusser, Matthias [Auteur]
Medizinische Universität Wien = Medical University of Vienna
Soffietti, Riccardo [Auteur]
Università degli studi di Torino = University of Turin [UNITO]
Von Baumgarten, Louisa [Auteur]
Westphal, Manfred [Auteur]
Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] [UKE]
Weller, Michael [Auteur]
University hospital of Zurich [Zurich]
Tonn, Joerg-Christian [Auteur]
Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München [LMU]
Le Rhun, Emilie [Auteur]

309388|||University hospital of Zurich [Zurich]
Vogelbaum, Michael A. [Auteur]
University of South Florida [Tampa] [USF]
Van Den Bent, Martin J. [Auteur]
Erasmus University Medical Center [Rotterdam] [Erasmus MC]
Grau, Stefan J. [Auteur]
Preusser, Matthias [Auteur]
Medizinische Universität Wien = Medical University of Vienna
Soffietti, Riccardo [Auteur]
Università degli studi di Torino = University of Turin [UNITO]
Von Baumgarten, Louisa [Auteur]
Westphal, Manfred [Auteur]
Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] [UKE]
Weller, Michael [Auteur]
University hospital of Zurich [Zurich]
Tonn, Joerg-Christian [Auteur]
Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München [LMU]
Journal title :
European Journal of Cancer
Abbreviated title :
Eur J Cancer
Volume number :
156
Pages :
93-108
Publication date :
2021-08-20
ISSN :
1879-0852
Keyword(s) :
CNS
Cerebral
Metastasis
Quality of life
Neurological surgery
Cerebral
Metastasis
Quality of life
Neurological surgery
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Recent therapeutic advances involving the use of systemic targeted treatments and immunotherapeutic agents in patients with advanced cancers have translated into improved survival rates. Despite the emergence of such ...
Show more >Recent therapeutic advances involving the use of systemic targeted treatments and immunotherapeutic agents in patients with advanced cancers have translated into improved survival rates. Despite the emergence of such promising pharmacological therapies and extended survival, the frequency of metastases in the central nervous system has steadily increased. Effective medical and surgical therapies are available for many patients with brain metastases and need to be incorporated into multi-disciplinary care protocols. The role of neurosurgeons is evolving within these multi-disciplinary care teams. Surgical resection of brain metastases can provide immediate relief from neurological symptoms due to large lesions and provides the histopathological diagnosis in cases of no known primary malignancy. In situations where immunotherapy is part of the oncological treatment plan, surgery may be proposed for expeditious relief of edema to remove the need for steroids. In patients with multiple brain metastases and mixed response to therapeutics or radiosurgery, tumour resampling allows tissue analysis for druggable targets or to distinguish radiation effects from progression. Ventriculo-peritoneal shunting may improve quality of life in patients with hydrocephalus associated with leptomeningeal tumour dissemination and may allow for time to administer more therapy thus prolonging overall survival. Addressing the limited efficacy of many oncological drugs for brain metastases due to insufficient blood-brain barrier penetrance, clinical trial protocols in which surgical specimens are analysed after pre-surgical administration of therapeutics offer pharmacodynamic insights. Comprehensive neurosurgical assessment remains an integral element of multi-disciplinary oncological care of patients with brain metastases and is integral to tumour biology research and therapeutic advancement.Show less >
Show more >Recent therapeutic advances involving the use of systemic targeted treatments and immunotherapeutic agents in patients with advanced cancers have translated into improved survival rates. Despite the emergence of such promising pharmacological therapies and extended survival, the frequency of metastases in the central nervous system has steadily increased. Effective medical and surgical therapies are available for many patients with brain metastases and need to be incorporated into multi-disciplinary care protocols. The role of neurosurgeons is evolving within these multi-disciplinary care teams. Surgical resection of brain metastases can provide immediate relief from neurological symptoms due to large lesions and provides the histopathological diagnosis in cases of no known primary malignancy. In situations where immunotherapy is part of the oncological treatment plan, surgery may be proposed for expeditious relief of edema to remove the need for steroids. In patients with multiple brain metastases and mixed response to therapeutics or radiosurgery, tumour resampling allows tissue analysis for druggable targets or to distinguish radiation effects from progression. Ventriculo-peritoneal shunting may improve quality of life in patients with hydrocephalus associated with leptomeningeal tumour dissemination and may allow for time to administer more therapy thus prolonging overall survival. Addressing the limited efficacy of many oncological drugs for brain metastases due to insufficient blood-brain barrier penetrance, clinical trial protocols in which surgical specimens are analysed after pre-surgical administration of therapeutics offer pharmacodynamic insights. Comprehensive neurosurgical assessment remains an integral element of multi-disciplinary oncological care of patients with brain metastases and is integral to tumour biology research and therapeutic advancement.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
INSERM
Université de Lille
Université de Lille
Collections :
Submission date :
2022-06-15T14:00:28Z
2023-03-01T10:29:54Z
2023-04-21T10:52:46Z
2023-03-01T10:29:54Z
2023-04-21T10:52:46Z
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