Stereotactic Radiosurgery and Targeted Therapies for Brain Metastases from Solid Cancers
Berrin Pehlivan
Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey.
Erkan Topkan
*
Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey.
Ahmet Kucuk
Radiation Oncology Clinics, Mersin City Education and Research Hospital, Mersin, Turkey.
Ayse Okumus
Radiation Oncology Clinics, Yeni Yuzyil University, Gaziosmanpasa Hospital, Istanbul, Turkey.
Duygu Sezen
epartment of Radiation Oncology, Koc University, School of Medicine, Istanbul, Turkey.
Yasemin Bolukbasi
Department of Radiation Oncology, Koc University, School of Medicine, Istanbul, Turkey.
Ugur Selek
Department of Radiation Oncology, Koc University, School of Medicine, Istanbul, Turkey. and Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA.
*Author to whom correspondence should be addressed.
Abstract
Perpetual advances in the diagnostic tools, local plus systemic cancer treatments, and ensued lengthened survival times led to striking increments in the incidence rates of brain metastases (BMs), with a collective incidence range of 20-40% for all solid cancers. Stereotactic radiosurgery (SRS) and innovative molecularly targeted therapies are continuously gaining growing significance in the triumphant management of BMs, as the brain represents a sanctuary site for the vast majority of the conventional cytotoxic chemotherapies. In this scenario, the molecularly targeted agents appear to be an attractive alternative to traditional chemotherapeutics as they can modulate cancer metabolism and progression and exert synergism with radiation therapy. Therefore, the present paper intends to sum up the accessible proof on the consolidated utilization of SRS and molecularly targeted agents in the precise management of BMs from certain solid cancers, specifically the non-small-cell lung, breast, and renal-cell carcinomas, and malignant melanomas.
Keywords: Brain metastases, stereotactic radiosurgery, targeted therapy, tumor control, toxicity.