Metastatic disease of the nervous system / volume editors, David Schiff and Martin J. van den Bent.

Format:

Book

Contributor:

Schiff, David, 1959- editor.

Bent, Martin J. van den, editor.

Series:

Handbook of clinical neurology ; Volume 149.

Handbook of Clinical Neurology ; Volume 149

Language:

English

Subjects (All):

Brain metastasis.

Physical Description:

1 online resource (304 pages) : illustrations, tables.

Edition:

1st ed.

Place of Publication:

Amsterdam, Netherlands : Elsevier, 2018.

Summary:

Metastatic Disease of the Nervous System, Volume 149, begins with an overview of the impact and range of direct neoplastic involvement of the central and peripheral nervous system, comprehensively reviewing all aspects of brain metastases, from clinical, radiological and neuropathological manifestations, to the roles of surgery, radiation, systemic and palliative therapy in their management, and the complications of these interventions. The clinical manifestations, diagnosis and treatment of leptomeningeal, dural, spinal epidural and plexus metastases are also covered in detail.- Covers all aspects of brain metastases, from clinical, radiological and neuropathological manifestations, to the roles of surgery, radiation, systemic and palliative therapy- Presents a multidisciplinary review of the evidence regarding accuracy of diagnostic testing and evidence-based reviews of therapies- Addresses metastatic diseases of the nervous system for residents, fellows and clinicians in neurology and oncology

Contents:

Front Cover

Metastatic Disease of the Nervous System

Copyright

Foreword

Preface

Contributors

Contents

Section I: Overview

Chapter 1: Overview of metastatic disease of the central nervous system

Brain metastases

Epidemiology and biology

Survival

Treatment

Lung

Melanoma

Breast

Colorectal/gastric

Renal

Leptomeningeal metastases

Metastases involving spinal cord, plexus, roots, and skull base

Spinal metastases

Metastases to plexus

Dural metastases

Skull base

Acknowledgment

References

Section II: Brain metastases

Chapter 2: Brain metastases: epidemiology

Introduction

Incidence of brain metastases

Autopsy studies

Population-based studies

Incidence by age

Brain metastases in children

Number and location of metastases

Primary cancer site

Lung cancer

Non-small cell lung cancer

Small cell lung cancer

Breast cancer

Colon and other gastrointestinal cancers

Colorectal cancer

Esophageal cancer

Other gastrointestinal cancers

Genitourinary cancers

Renal cell carcinoma

Bladder cancer

Prostate cancer

Testicular cancer

Gynecologic cancers

Ovarian cancer

Endometrial cancers

Choriocarcinoma

Unknown primary

Conclusion

Chapter 3: Pathogenesis and biology

How to study the biology of brain metastasis

Hints for a premetastatic niche in the brain

Brain-metastasizing cancer cells: the seed

The brain-metastatic cascade

The blood-brain barrier: a special gate keeper

A perivascular niche for cancer cell survival, dormancy, and stem-like capacity in the brain

Cancer cell survival

Stem-like capacity

Dormancy

Immune modulation

The brain microenvironment: friend or foe for metastatic tumor cells?

Astrocytes

Microglia

Neurons

T cells.

Successful growth in the brain by blood vessel interactions

Molecular biology of brain metastatic cells

Conclusions and outlook

Chapter 4: Role of the blood-brain barrier in metastatic disease of the central nervous system

Physiology of the blood-brain barrier

The blood-tumor barrier

Impact of the blood-brain/blood-tumor barrier on systemic treatment of brain metastases

How to measure blood-brain/blood-tumor barrier permeability of a certain compound in brain metastases

Improving the delivery of therapeutic agents to brain metastases and brain parenchyma

Direct application

Dosing adjustments of systemic treatments

Temporary disruption of the blood-brain barrier

Role of radiotherapy in blood-brain/blood-tumor barrier permeability

Engineering drug properties

How to address blood-brain/blood-tumor barrier permeability in clinical trial planning

Conclusions

Chapter 5: Metastatic diseases of the central nervous system - neuropathologic aspects

Origin of CNS metastases

Location

Macroscopy

Histopathology

Ancillary studies

Metastatic lesions post radiation treatment

Chapter 6: Brain metastasis: clinical manifestations, symptom management, and palliative care

Clinical manifestations

Focal neurologic symptoms

Cognitive dysfunction

Neurocognitive function after cancer treatment

Fatigue

Headache

Seizures and anticonvulsant management

Anticonvulsants

Corticosteroids

Palliative care and end-of-life decision making

Chapter 7: Brain metastases: neuroimaging

CT and MR: standard imaging, location, general appearance

Enhancing detection of small metastases.

Principles underlying advanced imaging techniques (table 7.1)

Perfusion imaging

Diffusion-weighted imaging

Diffusion tensor imaging (DTI)

MR spectroscopy (MRS)

Positron emission tomography

Non-FDG PET

Differentiating metastases from similar-appearing masses

Determining underlying primary tumor

Treatment planning

Typical treatment response imaging changes

Early response markers

Caveats to interpreting posttreatment imaging changes

Radiation necrosis

Immunotherapy

Predicting response prior to treatment initiation (prognostic markers)

Chapter 8: The role of surgery for brain metastases from solid tumors

Indication for surgery

Prognostic assessment for brain metastases patients

Microsurgical resection of newly diagnosed brain metastases

The impact of surgery on prognosis

Surgery in recurrent tumors and carcincomatous meningitis

Interstitial brachytherapy for brain metastases

Future perspectives

Chapter 9: Brain metastases: fractionated whole-brain radiotherapy

Background and prognostication

The role of palliative whole-brain radiotherapy

Adjuvant whole-brain radiotherapy after resection

Stereotactic radiosurgery and adjuvant whole-brain radiotherapy

Hippocampal avoidance whole-brain radiotherapy

Neuroprotective pharmacologic therapy

Ongoing studies with whole-brain radiotherapy

Chapter 10: Brain metastases: radiosurgery

Radiosurgery versus whole-brain radiotherapy

Radiosurgery versus surgical resection

Radiosurgery for surgically inaccessible tumors

Predictors of local control after radiosurgery

Adverse radiation events after SRS

Combining radiosurgery and targeted therapies.

Combining radiosurgery and immunotherapies

Conclusions: surveillance screening and stereotactic radiosurgery

Chapter 11: Systemic therapy for brain metastases

The biology and unique challenges in using systemic treatment for brain metastases

Brain metastases from lung cancer

Nonsmall cell lung cancer

Chemotherapy

Targeted therapy: EGFR tyrosine kinase inhibitors

Targeted therapy: ALK tyrosine kinase inhibitors

Targeted therapy: vascular endothelial growth factor inhibitor

Breast cancer brain metastases

Systemic therapies

Hormone receptor-positive

Triple-negative

HER-2-positive

Anti-VEGF therapy

Immune checkpoint inhibitors

Other systemic agents

Melanoma brain metastases

Chemotherapy for melanoma brain metastases

Targeted therapy for melanoma brain metastases

Immunotherapy for melanoma brain metastases

Chapter 12: Neurocognitive aspects of brain metastasis

Impact of prior therapies: chemotherapy-related neurocognitive impairment

Impact of tumor: neurocognitive function in brain metastasis patients at diagnosis

Neurocognitive effects of therapeutic approaches to manage brain metastases

Surgery

Surgical innovations: laser therapy and chemotherapy wafers

Systemic agents

Local radiotherapy

Stereotactic radiosurgery

Whole-brain radiotherapy

Therapeutic whole-brain radiotherapy

Prophylactic cranial irradiation

Neurocognitive function in clinical trials: performance-based tests

Section III: Other nervous system metastases

Chapter 13: Leptomeningeal metastasis

Epidemiology and risk factors

Pathogenesis

Diagnosis

Clinical features

Cerebrospinal fluid examination.

Cytology

Biomarkers

CSF flow cytometry

Circulating tumor cells

CSF circulating tumoral cell-free DNA (cfDNA) or "liquoral liquid biopsy"

Neuroradiographic studies

CSF flow radionuclide studies

Meningeal biopsy

Staging

Differential diagnosis

Symptomatic treatment and supportive care

Radiation therapy

Cytotoxic therapy, newly developed targeted and immunobiological therapies

Intra-CSF therapy

Lumbar intrathecal or intraventricular route of administration

Techniques of intra-CSF administration

Drugs available for intra-CSF treatment

Methotrexate

Cytosine arabinoside (cytarabine)

Thiotepa

Combination (multiagent) intra-CSF chemotherapy with systemic treatment

Investigational intra-CSF therapies

Intra-CSF etoposide

Intra-CSF topotecan

Biologic agents

Monoclonal antibodies

Systemic treatment

Classical and historic approach of systemic treatment

New therapeutic approaches in systemic treatment: specific chemotherapies, targeted therapies, immunotherapy, investigational

Systemic treatments in breast cancer patients

Toxicity and complications of LM-directed treatment

Response assessment in daily practice and clinical trials

Survival and prognostic factors

Abbreviations

Chapter 14: Intracranial dural, calvarial, and skull base metastases

Epidemiology

Pathophysiology

Clinical presentation

Prognosis

Metastases to the calvarium and skull base

Calvarial metastases

Anatomy

Diagnostic evaluation

Management

Radiation

Medical

Skull base metastases

Epidemiology.

Pathophysiology.

Notes:

Includes bibliographical references at the end of each chapters and index.

Description based on online resource; title from PDF title page (EBC, viewed February 5, 2018).

ISBN:

9780444638793

0444638792

9780128111611

0128111615