Intracerebral metastases surgery

Intracerebral metastases Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Surgery is not the first-line treatment option for patients with intracerebral metastases. Surgical resection is usually reserved for patients with either a solitary brain metastasis or no extracranial spread of the primary tumor. Sterotactic radiosurgery is indicated if there are multiple (<3) but small metastatic masses.

Surgery

Stereotactic Radiosurgery

• Stereotactic radiosurgery is a type of external beam radiation therapy that allows radiation beams to be given to a specific area in the brain.
• This therapy aims many small beams of radiation from different directions at the tissue to be treated.
• It can direct the beams with precision to lessen the radiation to surrounding tissues, hence it causes less damage to healthy tissue than whole brain radiation therapy.
• A single large dose of radiation is given.
• Indications for stereotactic radiation therapy include:

• One or a few metastatic brain tumors

• Stereotactic radiosurgery is usually used to treat people with upto 3 small-sized metastatic brain tumors

• Alone or in combination with whole brain radiation therapy (WBRT)
• Progressive or recurrent brain metastases

• Stereotactic radiotherapy may be given after the person has had whole brain radiation therapy

Surgical Resection

Surgery is not the first-line treatment option for patients with intracerebral metastases. Surgical resection is usually reserved for patients with either:

• Solitary brain metastasis
• No extracranial spread of the primary

The role of surgery in treatment of intracerebral metastases include:

• Reduction of the size of the tumor as much as possible (debulking), if the metastasis is deep or is growing into the brain tissue and causing problems
• Reduction of the intracranial pressure
• Relief from the symptoms, if a brain metastasis cannot be completely resected

References

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