The incidence of primary malignant brain tumors is increasing, especially in the elderly, and metastatic disease to the central nervous system (CNS) occurs even more frequently (an incidence about 10 times that of primary brain tumors). In fact, estimates are that 20% to 40% of patients with systemic cancer will develop brain metastases. Primary and metastatic brain tumors are heterogeneous, with varied outcomes and management strategies. This marked heterogeneity means that prognostic features and treatment options must be carefully reviewed for each patient. As these guidelines note, the involvement of an interdisciplinary team is key in the appropriate management of these patients. Important updates to the guidelines include the addition of systemic chemotherapy as a salvage therapy treatment option for local recurrence and limited metastatic lesions and its deletion as an option for multiple metastatic lesions.
For the most recent version of the guidelines, please visit NCCN.org
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The University of Michigan Comprehensive Cancer Center was established in 1986 and soon after designated a “comprehensive” center by the National Cancer Institute. Michigan's team approach to both research and patient care is reflected in its mission: the conquest of cancer through innovation and collaboration. Under the direction of Max S. Wicha, MD (second photo on cover), an internationally known researcher in cancer stem cell biology and an active clinician, the center's 388 physicians and researchers work together in multidisciplinary teams to rapidly translate new prevention, detection, and treatment discoveries to benefit cancer patients.Groundbreaking research efforts are under way there, including research into cancer stem cells in multiple tumor types, cancer genetics, and targeted molecular therapies. In 2007, the U-M Cancer Center launched the Ravitz Foundation Phase I/Translational Research Center to speed the development of innovative therapies by fostering the transition from the laboratory to the bedside.In addition, the University of Michigan Comprehensive Cancer Center looks at healing the whole person, not just the disease, offering comprehensive patient and family support services—including patient education, complementary therapies and psych oncology services—to ease the stress of serious illness.