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Vol. 34. Issue 6.
Pages 308-320 (November - December 2023)
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Vol. 34. Issue 6.
Pages 308-320 (November - December 2023)
Special article
Brain metastasis treatment guidelines: consensus by the Spanish Society of Neurosurgery Tumor Section
Consenso sobre el tratamiento neuroquirúrgico de las metástasis intracraneales elaborado por el Grupo de Trabajo de Neurooncología (GTNO) de la Sociedad Española de Neurocirugía
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Sonia Tejada Solísa,
Corresponding author
stejadasolis@yahoo.es

Corresponding author.
, Irene Iglesias Lozanob, Leonor Meana Carballoc, Manuela Mollejo Villanuevad, Ricardo Díez Vallea, Josep González Sáncheze, Alejandro Fernández Coellof, Rajab Al Ghanemg, Sara García Duqueh, Gonzalo Olivares Granadosi, Gerard Plans Ahicartf, Cristina Hostalot Paniselloj, Juan Carlos Garcia Romerok, Jose Luis Narros Giménezk, Grupo de trabajo de la SENEC
a Departamento de Neurocirugía, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
b Departamento de Neurocirugía, Hospital Universitario Puerta del Mar, Cádiz, Spain
c Departamento de Neurocirugía, Centro Médico de Asturias, Spain
d Departamento de Anatomía Patológica, Complejo Hospitalario de Toledo, Spain
e Departamento de Neurocirugía, Hospital Clínic y Provincial de Barcelona, Spain
f Departamento de Neurocirugía, Hospital Universitari Bellvitge, Spain
g Departamento de Neurocirugía, Hospital Universitario de Jaén, Spain
h Departamento de Neurocirugía, Hospital Universitario HM Montepríncipe, Spain
i Departamento de Neurocirugía, Hospital Virgen de las Nieves de Granada, Spain
j Departamento de Neurocirugía, Hospital Germans Trias i Pujol, Spain
k Departamento de Neurocirugía, Hospital Universitario Virgen del Rocio, Spain
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Table 1. Immunohistochemical markers and possible therapeutic targets.
Table 2. Summary of response criteria for CNS metastases proposed by Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM).7
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Abstract

Brain metastases are tumors that arise from a tumor cell originated in another organ reaching the brain through the blood. In the brain this tumor cell is capable of growing and invading neighboring tissues, such as the meninges and bone.

In most patients a known tumor is present when the brain lesion is diagnosed, although it is possible that the first diagnose is the brain tumor before there is evidence of cancer elsewhere in the body.

For this reason, the neurosurgeon must know the management that has shown the greatest benefit for brain metastasis patients, so treatments can be streamlined and optimized.

Specifically, in this document, the following topics will be developed: selection of the cancer patient candidate for surgical resection and the role of the neurosurgeon in the multidisciplinary team, the importance of immunohistological and molecular diagnosis, surgical techniques, radiotherapy techniques, treatment updates of chemotherapy and immunotherapy and management algorithms in brain metastases.

With this consensus manuscript, the tumor group of the Spanish Society of Neurosurgery (GT-SENEC) exposes the most relevant neurosurgical issues and the fundamental aspects to harmonize multidisciplinary treatment, especially with the medical specialties that are treating or will treat these patients.

Keywords:
Brain metastasis
Consensus
Treatment guideline
Surgery brain tumor
Resumen

Las metástasis cerebrales (MC) son tumores que se forman a partir de una célula tumoral originada en otro órgano y que a través de la sangre llega al cerebro donde es capaz de crecer e invadir los tejidos vecinos, como meninges y hueso.

En la mayor parte de los pacientes existe un tumor conocido cuando se diagnostica la lesión cerebral, aunque es posible que el tumor del cerebro sea el primer hallazgo antes de que se tenga evidencia de la patología oncológica en otro lugar del organismo.

Por este motivo, el neurocirujano debe conocer el manejo que ha demostrado mayor beneficio para estos sujetos, de manera que se agilicen y optimicen los tratamientos.

Concretamente, en este documento se desarrollarán, entre otros temas: la selección del paciente oncológico candidato a la resección quirúrgica y el papel del neurocirujano en el equipo multidisciplinar, la importancia del diagnóstico inmunohistológico y molecular, técnicas quirúrgicas y de RT, actualización de tratamientos de quimioterapia e inmunoterapia y algoritmos de manejo en MC.

Con este manuscrito de consenso, el Grupo de Tumores de la Sociedad Española de Neurocirugía (GT- SENEC) expone las cuestiones neuroquirúrgicas más relevantes y los aspectos fundamentales para armonizar el tratamiento multidisciplinar, sobre todo con las especialidades médicas que estén tratando o vayan a abordar a estos pacientes.

Palabras clave:
Metástasis cerebral
Consenso
Guía de tratamiento
Cirugía de tumor cerebral

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