Author:
Kwan Carolyn Tang Hiu,Wee Ho Joon
Abstract
Central nervous system (CNS) metastases are a common manifestation of malignant melanoma, with a median overall survival of as little as 4.7 months based on a study of patients diagnosed between 1986 and 2004 prior to the era of effective systemic therapy. Yet most of the clinical trials exclude patients with intra-cranial metastases. CNS involvement often causes neurological deficits and functional impairment. Localised therapies, such as surgical excision and stereotactic radiotherapy are applicable to only a minority of patients. There are evidences of clinical benefits for immunotherapy than best supportive care and when given alongside radiotherapy provides a better overall survival than radiotherapy alone. This chapter evaluates the efficacy and toxicity of these treatments against advanced melanoma patients with brain metastases.