The incidence of primary malignant brain tumors increased over the past 30 years, especially in elderly persons.
Metastatic disease to the central nervous system (CNS) occurs much more frequently, with an estimated incidence approximately 10 times that of primary brain tumors.
Between 20% and 40% of patients with systemic cancer will develop brain metastases.
Primary and metastatic brain tumors are a heterogeneous group of neoplasms with varied outcomes and management strategies.
Primary brain tumors
range from pilocytic astrocytomas, which are very uncommon, noninvasive, and surgically curable, to glioblastoma multiforme, the most common intraparenchymal brain tumor in adults, which is highly invasive and virtually incurable.
Patients with metastatic brain disease
may have rapidly progressive systemic disease or no systemic cancer at all - they may have one or dozens of brain metastases, and may have a malignancy that is either highly responsive or highly resistant to radiation or chemotherapy.
Because of this heterogeneity, the prognostic features and treatment options for brain tumors must be carefully reviewed on an individual basis.
CNS tumors are associated with a range of symptoms and complications - edema, seizures, endocrinopathy, fatigue, psychiatric disorders, and venous thromboembolism - which
can seriously impact quality of life.
Involvement of an interdisciplinary team, including neurosurgeons, radiation therapists, oncologists, neurologists, and neuroradiologists, is a key factor in the appropriate management of these patients.
See reference for details.
Adapted from Brem SS. Central nervous system cancers. JNCCN–Journal of the National Comprehensive Cancer Network, Volume 9 Number 4, 2011. Internet. Accessed on May 28, 2016.