DOI: https://doi.org/10.22141/oncology.1.1.2018.155380

Prognosis of the course and systemic therapy of patients with brain metastases of solid tumors (literature review)

R.V. Liubota, R.I. Vereschako, M.F. Anikusko, I.I. Liubota, Ya.M. Prykhodko

Abstract


The review deals with the systemic therapy of patients with brain metastases taking into account the prognosis of the oncological disease. Considering the fact that the presence of brain metastases significantly worsens the prognosis of the course, this article presents an overview of scales for predicting the survival of patients with brain metastases, their characteristics taking into account the application both in routine clinical practice and in clinical trials. Brain metastases occur 10 times more often than primary tumors of the central nervous system and are diagnosed in 10–20 % of cancer patients. Given the prevalence and the absence of generally accepted clinical recommendations for the treatment of patients with brain metastases, this paper reviews the existing prognostic factors determining the treatment tactics, presents data on the role of the blood brain barrier in the pathogenesis and efficacy of the brain metastases therapy. Possible mechanisms of resistance to systemic antitumor therapy, ways to overcome them were considered, as well as the results of studies on the effectiveness of systemic antitumor therapy in patients with brain metastases of the solid tumors. This review of literature indicates the importance of applying a multidisciplinary approach to determining the treatment mode with the use of scales for assessing the prognosis of course, which, in turn, will lead to a more justified prescription of radiation therapy, surgical treatment, systemic antitumor and symptomatic therapy in order to preserve neurological and neurocognitive function, and the quality of life of patients.

Keywords


brain metastases; blood-brain barrier; prognosis of survival; systemic antitumor therapy; radiotherapy; palliative treatment; review

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