RADIOTHERAPY AND TARGETED THERAPY IN PATIENTS WITH METASTATIC BRAIN LESION: NEW TREATMENT OPTIONS

Abstract

Metastases in the brain are the most common malignant brain tumor. A multidisciplinary approach including radiotherapy, surgery and chemotherapy is used to treat patients with brain metastases depending on the prevalence of the tumor process and symptomatology. In recent years there was a steady trend of transition from conventional to conformal radiotherapy. A confirmation of this fact is the creation and clinical implementation of the principles of stereotactic radiotherapy (in the mode of radiosurgery or hypofractionation), which in fact changed the paradigm of local treatment of patients with metastases in the brain. On the other hand the evolution of drug treatment of malignant tumors led to the creation of a new direction - targeted therapy, which significantly changed the treatment of cancer patients. The combination of radiotherapy and targeted therapy contributed to further individualization of treatment, potentially eliminating the need for cytotoxic chemotherapy or whole brain irradiation. At present the effectiveness and safety of the combination of radiotherapy and targeted therapy are being studied, the results of which will determine the place and role of the treatment technique in treatment of patients with metastatic brain lesion. This review summarizes the available literature data of a combination of radiotherapy and targeted therapy in patients with metastatic brain lesion with an emphasis on survival, local control, distant metastasis and post-radiation complications.