Brain metastases guidelines

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• Current Treatment Paradigms for Advanced Melanoma with Brain Metastases
• MRI-based machine learning reveals proteasome subunit PSMB8-mediated malignant glioma phenotypes through activating TGFBR1/2-SMAD2/3 axis
• Hyderabad (Sindh, Pakistan) Cancer Registry Report of Four Years (2020-2023)
• Intraoperative superb microvascular ultrasound imaging in glioma: novel quantitative analysis correlates with tumour grade
• Response Assessment in Neuro-Oncology (RANO) 2009-2025: Broad Scope and Implementation - A Progress Report
• Electron-beam FLASH whole brain irradiation induced a unique changes of intestinal flora

The EANO–ESMO Clinical Practice Guidelines (2021) provide comprehensive recommendations for the diagnosis, brain metastases treatment, and follow-up of patients with brain metastases (BMs) originating from solid tumors. These guidelines are a collaborative effort between the European Association of Neuro-Oncology (EANO) and the European Society for Medical Oncology (ESMO).

Brain metastases treatment guidelines.

* Neuroimaging: Magnetic Resonance Imaging (MRI) with contrast is the preferred modality for detecting BMs. Recommended sequences include pre- and post-contrast T1-weighted, T2-weighted, T2-FLAIR, and diffusion-weighted imaging.

* Screening: Routine brain imaging is advised for patients with certain high-risk cancers, such as:

• Stage IV melanoma

• Metastatic HER2-positive or triple-negative breast cancer

• Non-small-cell lung cancer (NSCLC), excluding stage I

* Surgery: Considered for patients with a single brain metastasis or multiple resectable lesions, especially if they present with significant mass effect or require histological diagnosis.

* Stereotactic Radiosurgery (SRS):

• Recommended for patients with 1–4 brain metastases.
• May be considered for those with 5–10 metastases, provided the cumulative tumor volume is less than 15 mL.

* Whole-Brain Radiotherapy (WBRT): Reserved for patients with multiple brain metastases not amenable to SRS or surgery.

* Systemic Therapy:

• Treatment should be tailored based on the histological and molecular characteristics of the primary tumor.
• When feasible, molecular profiling of the brain metastasis itself is recommended to guide targeted therapies.([reference.medscape.com][3])

* Imaging: Regular MRI scans are essential to monitor treatment response and detect disease progression.

* Multidisciplinary Approach: Optimal management involves collaboration among neuro-oncologists, medical oncologists, radiation oncologists, neurosurgeons, and other specialists.

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For detailed information, you can access the full guidelines here: 👉 [EANO–ESMO Clinical Practice Guidelines for Brain Metastases](https://www.eano.eu/publications/eano-guidelines/eano-esmo-clinical-practice-guidelines-for-diagnosis-treatment-and-follow-up-of-patients-with-brain-metastasis-from-solid-tumours/)

[1]: https://link.springer.com/article/10.1007/s00259-024-07038-5?utm_source=chatgpt.com “Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for …” [2]: https://btrt.org/DOIx.php?id=10.14791%2Fbtrt.2023.0049&utm_source=chatgpt.com “Clinical Practice Guidelines for Brain Metastasis From Solid Tumors” [3]: https://reference.medscape.com/viewarticle/963816?utm_source=chatgpt.com “Brain Metastasis Clinical Practice Guidelines (EANO/ESMO, 2021)”