The management of brain metastases (BM) remains an important and complex issue in the treatment of cancer-related neurological complications. BM are particularly common in patients diagnosed with lung, melanoma, or breast cancer. Over the past decade, therapeutic approaches for the majority of BM patients have changed. Considering and addressing the fact that patients with BM are living longer, the need to provide effective local control while preserving quality of life and neurocognition is fundamental. Over the past decade, SRS and SRT have become a more commonly chosen treatment option for BM. Despite significant advances in the treatment of BM, numerous questions remain regarding patient selection and optimal treatment sequencing. Clinical trials are critical to advancing our understanding of BM, especially as more therapeutic alternatives become available. Therefore, it is imperative for interdisciplinary teams to improve their understanding of the latest advances in SRS-SRT. This review aims to comprehensively explore SRS and SRT as treatments for BM, covering clinical considerations in their application (e.g., patient selection and eligibility), managing limited and multiple intact BM, addressing brainstem metastases, exploring combination therapies with systemic treatments, and considering the health economic perspective.
脑转移瘤（BM）的管理仍是癌症相关神经系统并发症治疗中一个重要且复杂的问题。脑转移瘤在确诊为肺癌、黑色素瘤或乳腺癌的患者中尤为常见。过去十年间，大多数脑转移瘤患者的治疗方法已发生改变。考虑到脑转移瘤患者生存期延长的事实，在维持生活质量和神经认知功能的同时提供有效的局部控制已成为治疗的根本需求。近十年来，立体定向放射外科（SRS）和立体定向放射治疗（SRT）已成为脑转移瘤更常选择的治疗方案。尽管脑转移瘤治疗取得显著进展，但在患者选择和最佳治疗顺序方面仍存在诸多问题。临床试验对推进我们对脑转移瘤的理解至关重要，尤其是在更多治疗选择不断涌现的背景下。因此，跨学科团队必须加强对SRS-SRT最新进展的理解。本综述旨在全面探讨SRS和SRT作为脑转移瘤的治疗方法，涵盖其临床应用中的临床考量（如患者选择与适应症）、有限及多发完整脑转移瘤的处理、脑干转移瘤的治疗、与全身治疗的联合方案探索，以及健康经济学视角的考量。
肿瘤(癌症)患者之家