ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2018-1-1-7-14ojrdrt-7Research ArticleЛУЧЕВАЯ ТЕРАПИЯRADIOTHERAPYЛучевое лечение пациентов с ограниченным метастатическим поражением головного мозгаRadiotherapy of Patients with Limited Brain MetastasesБановС. М.BanovS. M.

Moscow

smbanov@gmail.comГолановА. В.GolanovA. V.

Moscow

ВетловаЕ. Р.VetlovaE. R.

Moscow

ДургарянА. А.DurgaryanA. A.

Moscow

Национальный медицинский исследовательский центр нейрохирургии им. Н.Н. Бурденко Минздрава РоссииРоссияN.N. Burdenko National Scientific and Practical Center for NeurosurgeryRussian Federation20183003201811714Copyright © Банов С.М., Голанов А.В., Ветлова Е.Р., Дургарян А.А., 20182018Банов С.М., Голанов А.В., Ветлова Е.Р., Дургарян А.А.Banov S.M., Golanov A.V., Vetlova E.R., Durgaryan A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/7

Метастатическое поражение головного мозга является наиболее часто встречающейся опухолью головного мозга. Без лечения прогноз выживаемости пациентов с метастазами в головной мозг негативный с быстрым ухудшением неврологического и функционального статуса. Прогноз выживаемости пациентов зависит от количества метастазов в головном мозге, экстракраниальной распространенности болезни и состояния функционального статуса. Исходя из этого, ограниченное метастатическое поражение головного мозга является фактором лучшего прогноза выживаемости. Вопрос об оптимальной терапевтической стратегии у пациентов этой группы еще не решен. Облучение всего головного мозга улучшает неврологический статус пациента, снижает риск дистантного метастазирования, но вызывает нейрокогнитивные расстройства, что значительно ухудшает качество жизни пациентов с хорошим прогнозом общей выживаемости. Стереотаксическая лучевая терапия позволяет обеспечить высокий уровень локального контроля метастатических очагов, снизить тяжесть повреждения нормальной ткани мозга и сохранить качество жизни у большинства пациентов. Обсуждаются вопросы стратегии радиотерапевтического лечения у пациентов с ограниченным метастатическим поражением головного мозга.

Brain metastases represent the first cause of malignant brain tumor. Without radiation therapy, prognosis was poor with fast neurological deterioration, and a median overall survival of one month. Nowadays, therapeutic options depend on brain metastases presentation, extra brain disease, performance status. Therefore, for oligometastatic brain patients with a better prognosis, this therapeutic modality is controversial. In fact, whole-brain radiation therapy improves neurological outcomes, but it can also induce late neuro-cognitive sequelae for long-term survivors of brain metastases. Thus, in this strategy for preserving good cognitive functions, stereotactic radiation therapy is a promising treatment. Delivering precisely targeted radiation in few high-doses in one to four brain metastases, allows to reduce radiation damage to normal tissues and it should allow to decrease radiation-induced cognitive decline. In this paper, we will discuss about therapeutic strategies radiation therapy for limited brain metastases patients. 

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The authors declare that there are no conflicts of interest present.