caa a22 4500 477098304 CHVBK 20180405111534.0 cr unu---uuuuu 170330e19960201xx s 000 0 eng 10.1007/BF02625950 doi (NATIONALLICENCE)springer-10.1007/BF02625950 Schackert Gabriele Department of Neurosurgery, Clinic and Polyclinic of Neurosurgery, Medical Faculty "Carl Gustav Carus”, Technical University Dresden, Fetscherstraße 74, D-01307, Dresden, Germany aut Resection of brain metastases [Elektronische Daten] [Gabriele Schackert] Chirurgische Therapie von Hirnmetastasen Summary: Background: Approximately 25% of all cancer patients develop intracranial metastases, of which 40% to 60% are solitary. Most cerebral metastases derive from the lungs and breast. The highest incidence for brain metastases is associated with the malignant melanoma. Cerebral lesions develop as dural, leptomeningeal, and parenchymal metastases. The occurrence of brain metastases is often associated with the terminal stage of the disease and generalized metastasizing. Methods: Brain metastases become apparent by neurological symptoms, such as focal deficits, elevated intracranial pressure and epileptic seizures. The diagnosis will be confirmed by cerebral computed tomography. The performance of MRI-scan, however, is mandatory, in order to answer the question of multiple lesions. The treatment of choice is surgery and/or radiotherapy. Solitary lesions have to be operated on, especially when they can be approached easily and the patients' deficits will improve. Even multiple metastases can be approached by surgery. While radioresistant tumors should be operated on, radiosensitive tumors, such as the small-cell lung cancer, might be primarily treated by radiotherapy. Multiple, operatively non-accessible metastases and deeply-located lesions in the brain stem should not be operated on. Stereotactic radiosurgery has to be discussed. Results: The survival time mostly depends on the primary site of the tumor, the extent of the extracerebral metastases and the time interval between the initial diagnosis and the metastasis stage. Surgery plus radiation: The median survival time averages about 10 to 16 months, depending on the primary site of the tumor. Radiotherapy alone achieves a survival time of only 5 months. Conclusions: Surgery plus radiation is most effective in the treatment of cerebral metastases. Chemotherapy and immunotherapy are of limited success. Blackwell Science Ltd, 1996 Brain metastases nationallicence surgery nationallicence radiotherapy nationallicence Hirnmetastasen nationallicence Operation nationallicence Strahlentherapie nationallicence Acta Chirurgica Austriaca Springer-Verlag 28/1(1996-02-01), 18-23 0001-544X 28:1<18 1996 28 10353 https://doi.org/10.1007/BF02625950 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02625950 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Schackert Gabriele Department of Neurosurgery, Clinic and Polyclinic of Neurosurgery, Medical Faculty "Carl Gustav Carus”, Technical University Dresden, Fetscherstraße 74, D-01307, Dresden, Germany aut NATIONALLICENCE 773 0- Acta Chirurgica Austriaca Springer-Verlag 28/1(1996-02-01), 18-23 0001-544X 28:1<18 1996 28 10353 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer