Epidemiological, clinical and surgical aspects of metastatic brain tumors
Keywords:
brain tumor, metastatic brain tumors, brain metastasesAbstract
Introduction: tumors that spread in the brain, from a primary neoplasm located in other organs of the body are known as metastatic brain tumors. It is estimated that 25% of malignant tumors in other parts of the body cause head metastases.
Objective: to systematize the clinical, epidemiological and surgical aspects of metastatic brain tumors, as well as the diagnostic and therapeutic tools necessary to offer the patient and family the best alternatives to the disease.
Method: a narrative review was carried out based on the documentary study of systematic reviews, meta-analysis, clinical practice guides, original articles and doctoral theses that were found in the electronic databases.
Results: the incidence of brain metastasis varies depending on the location of the primary tumor. In adults, the highest incidence was observed between the fifth and seventh decade of life, without differences in sex. Brain tumors have different forms of clinical presentation, including intracranial hypertension syndrome, focal signs, epileptic seizures and endocrine syndrome. The three primary components of the management of patients with cerebral metastases were non-chemotherapeutic and chemotherapeutic drugs, surgical intervention for tumor excision and radiotherapy.
Conclusions: metastatic brain tumors constitute a health problem with increasing incidence, with a complex syndromic and polymorphic picture, they have a wide therapeutic arsenal that includes non-chemotherapeutic drugs, chemotherapy, surgery and radiotherapy which must be adjusted to the characteristics of each patient to achieve a survival as long as possible, with a better quality of life.
Downloads
References
2. OMS. Datos y cifras sobre el cáncer [en línea]. Geneva: OMS; 2019. [citado 31/08/19]. Disponible en: https://www.who.int/cancer/about/facts/es/
3. AANS. Metastatic Brain Tumors [en línea]. New Orleans: American Association of Neurological Surgeons; 2018 [citado 31 Ago 2019]. Disponible en: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Metastatic-Brain-Tumors
4. Goyenechea Gutiérrez FF, Hodelín Tablada R. Tumores del Sistema Nervioso Central. En: Goyenechea Gutiérrez FF, Pereira Riverón R, Hodelín Tablada R, et al. Neurocirugía. Lesiones del Sistema Nervioso. La Habana: Ciencias Médicas; 2014. p:134-148.
5. Patel AJ, Lang FF, Suki D, et al. Metastatic Brain Tumors. En: Winn HR. Yumans and Winn Neurological Surgery. 7a ed. Philadelphia: ELSEVIER; 2017. p:1091-1106.
6. Colectivo de autores. Tumores Intracraneales. En: Noya Chaveco ME, Moya González NL. Temas de Medicina Interna. 5a ed. La Habana: Ciencias Médicas; 2017. p:389-402.
7. Schmieder k, Keilholz U, Combs S. The Interdisciplinary Management of Brain Metastases. Dtsch ArzteblInt [en línea]. 2016 [citado 31 Ago 2019]; 113(24):415-421. Disponible en: https://www.aerzteblatt.de/int/archive/article/179923/The-interdisciplinary-management-of-brain-metastases
8. Greemberg MS. Tumor. En: Greemberg MS. Handbook of Neurosurgery. 6a ed. Atlanta: Thieme; 2006. p:355-470.
9. Hartman S. As Nation Focuses on Reforming Healthcare, Neurosurgeons Release the First Evidence-Based, Multidisciplinary Treatment Guidelines for Brain Metastases Patients [en línea]. New Orleans: AANS; 2009 [citado 31 Ago 2019]. Disponible en: http://www.aans.org/pdf/Legislative/BrainMetastasesTrtGuidelinesNewsRelease102609.pdf
10.Ministerio de Salud Pública. Anuario Estadístico de Salud, 2016 [en línea]. La Habana: MINSAP; 2017. [citado 31 Ago 2019]. Disponible en: http://files.sld.cu/dne/files/2017/05/Anuario_Estad%C3%ADstico_de_Salud_e_2016_edici%C3%B3n_2017.pdf
11.Weidle UH, Birzele F, Kollmorgen G, et al. Dissection of the Process of Brain Metastasis Reveals Targets and Mechanisms for Molecular-based Intervention. Cancer Genomic Proteomic [en línea]. 2016 Abr [citado 31 Ago 2019]; 13:245-258. Disponible en: http://cgp.iiarjournals.org/content/13/4/245.full.pdf+html
12.Cáceres Lavernia HH, Nenínger Vinageras E, Cristo Domínguez IS del. Combinación de radioterapia y Nimotuzumab en paciente con metástasis cerebral. Rev Electr Dr. Zoilo E. Marinello Vidaurreta [en línea]. 2015 [citado 31 Ago 2019]; 40(11):[aprox. 18 p.]. Disponible en: http://www.revzoilomarinello.sld.cu/index.php/zmv/article/view/359/pdf_145
13.Nuez Cobas E de la, Otaño Rodríguez A, Beltrán Sánchez PE, Cabarruiz Sánchez C, Álvarez Rodríguez Y. Metástasis cerebral de un cáncer mamario en paciente joven. Rev Cubana Med [en línea]. 2011 Mar [citado 31 Ago 2019]; 50(1):94-100. Disponible en: http://scielo.sld.cu/pdf/med/v50n1/med09110.pdf
14.Miranda Folch JJ, García Cuervo D, Vega Jiménez J, Alemán Marichal B, Jiménez Álvarez A, Castelnau Sánchez AR. Carcinoma de células renales: hipernefroma. Presentación de un caso. Rev Med Electr [en línea]. 2015 [citado 31 Ago 2019]; 37(3):[aprox. 8 p.]. Disponible en: http://www.revmedicaelectronica.sld.cu/index.php/rme/article/view/1214
15.Miller J, Hdeib A, Cohen A. Management of tumors of the fourth ventricle. En: Quiñones Hinojosa A. Operative Neurosurgical Techniques. Indications, Methods and Results. 6a ed. Philadelphia: ELSEVIER; 2012. p:367-397.
16.Siu T, Lang FF. Surgical management of cerebral metastases. En: Quiñones Hinojosa A. Operative Neurosurgical Techniques. Indications, Methods and Results. 6a ed. Philadelphia: ELSEVIER; 2012. p:178-191.
17.García Rodríguez ME, Armas Pérez B, Armas Moredo K, Álvarez Escalante G. Oligometástasis y oligorrecurrencia en el cáncer del pulmón: ¿estados cercanos a la muerte?. Rev Cubana Cir [en línea]. 2014 Jun [citado 31 Ago 2019]; 53(2):213-225. Disponible en: http://scielo.sld.cu/pdf/cir/v53n2/cir12214.pdf
18.Barker FG, Cahill DP. Brain Tumor Outcome Studies: Design and Interpretation. En: Winn HR. Yumans and Winn Neurological Surgery. 5a ed. Philadelphia: ELSEVIER; 2017. p:928-936.
19.Patel AJ, Lang FF, Suki D, Wildrick DM, Sawaya R. Metastatic Brain Tumors. En: Winn HR. Yumans and Winn Neurological Surgery. 5a ed. Philadelphia: ELSEVIER; 2017. p:928-936.
20.Lacerda Gallardo AJ, Estenoz Esquivel JC, Borroto Pacheco R. Metástasis cerebral. Estudio clinic quirúrgico y anatomopatológico. Rev Cubana Cir [en línea]. 2000 [citado 15 May 2019]; 39(2): 103-107. Disponible en: http://bvs.sld.cu/revistas/cir/vol39_2_00/cir03200.htm
21.Oliva Roselló MT. La radiocirugía duplica la esperanza de vida en casos de metástasis cerebral; 2014. Jano.es [citado 25 May 2019]. Disponible en: https://www.jano.es/noticia-la-radiocirugia-duplica-esperanza-vida-22686#
22.Marína A, Rennerb A, Itriagoa L, Álvarez M. Metástasis cerebrales: una mirada biológica y clínica. Rev Méd Clin Condes [en línea]. 2017 May [citado 15 May 2019]; 28(3):437-449. DOI: http://dx.doi.org/ 10.1016/j.rmclc.2017.05.010
23.Lovo IE, Torrealba MG, Villanueva GP, Gejman R, Tagle MP. Metástasis cerebral y sobrevida. Rev Méd Chile [en línea]. 2005 Feb [citado 28 Ago 2019]; 133(2):190-194. DOI: http://dx.doi.org/10.4067/S0034-98872005000200006
24.Ávila J. Supervivencia en pacientes con metástasis cerebrales tratados con radioterapia holocraneal. Rev Colomb Cancer [en línea]. 2018 Jul [citado 28 Ago 2019]; 22(3):99-104. DOI: http://dx.doi.org/10.1016/j.rccan.2018.07.002
25.Sanz Rubiales Á, Valle ML del, Ferreira R, López L. ¿Es diferente el pronóstico del glioblastoma multiforme y de las metástasis cerebrales? Med Paliat [en línea]. 2016 [citado 28 Ago 2019]; 24(3):171-172. DOI: http://dx.doi.org/10.1016/j.medipa.2015.12.002
