Treatment strategies for brain metastases in the era of molecular targeted therapy

Abstract

Molecular targeted therapy dramatically had changed the treatment of cancer patients, and the significant effect of this treatment on control of brain metastases had also been reported. The emergence of such new treatment requires reconsideration of therapeutic strategies for brain metastases. Molecular targeted therapy had no limitation of size and number of the intracranial lesions, but unfortunately were probably not curative and had risks of systemic adverse events. On the other hand, stereotactic radiation therapy may be curative for smaller brain metastases, but had limitations such as the size and the number of lesions. As described, molecular targeted therapy as systemic treatment and stereotactic radiation therapy as local treatment are not competitive treatments but complementary and coordinated treatments. Although how to coordinate these treatments is the future subject, the treatment strategy for each patient should be carefully discussed and decided by neurosurgeons, medical oncologists and radiation oncologists.