Herziene richtlijn ‘Hersenmetastasen’

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Nina A. Hilkens, Roelien H. Enting, Lizza E.L. Hendriks, Frank J. Lagerwaard, Filip Y.F.L. de Vos en J.M.M. (Anja) Gijtenbeek

Revised guideline ‘Brain metastases’: More treatment options

  • The guideline on brain metastasis from the Netherlands Society of Neurology has been updated. Important changes have been made, particularly with regard to treatment of brain metastases.
  • Treatment of patients with brain metastases is complex and requires a multidisciplinary approach to formulate an optimal, individualized treatment plan.
  • Neurosurgical resection may also be considered in patients with multiple brain metastases and one dominant, symptomatic lesion, if the patient is in good clinical condition.
  • Stereotactic radiosurgery is a treatment option for patients with a maximum of 10 brain metastases, depending on the size and number of metastases.
  • The indication for whole brain radiotherapy is relatively limited. Doctors should be cautious with whole brain radiotherapy in patients with a Karnofsky Performance Status <70.
  • In patients with small, asymptomatic brain metastases, targeted therapy or immune therapy may be considered without locoregional therapy.

Conflict of interest and financial support: potential conflicts of interest have been reported for this article. ICMJE forms provided by the authors are available online along with the full text of this article.