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Brain Sciences
Special Issues
Brain Metastases: Updates and Future Directions
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Brain Metastases: Updates and Future Directions

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuro-oncology".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 1676

Special Issue Editors

Dr. Aristotelis Kalyvas

E-Mail Website
Guest Editor
1. Division of Neurosurgery, University of Toronto, Toronto, ON, Canada
2. Department of Neurosurgery, National and Kapodistrian University of Athens, Athens, Greece
Interests: brain connectivity; brain mapping; white matter tracts; white matter fiber micro-dissection; tractography; brain cancer; brain metastases; glioma; pituitary tumors; endoscopic skull base approaches
Dr. Enrique Gutierrez-Valencia

E-Mail Website
Guest Editor Assistant
Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
Interests: brain metastases; neurosurgery; radiosurgery; neuro-oncology; SBRT; prostate cancer; brachytherapy for prostate cancer

Special Issue Information

Dear Colleagues,

We stand at the forefront of a transformative era in the diagnosis and management of brain metastases. Our Special Issue, entitled "Brain Metastases: Updates and Future Directions", seeks to capture these dynamic advancements, emphasizing groundbreaking approaches that are defining and reshaping the field.

This Special Issue will explore fundamental and translational science in brain metastases, novel surgical and radiation–oncology developments, and the role of emerging biomarkers in enhancing diagnostic and treatment strategies. With contributions covering advancements in AI and data sciences, pachymeningeal and leptomeningeal disease, and the latest in radiologic innovations, radiation oncology, surgical techniques, immunotherapy, and targeted therapies, we aim to provide a comprehensive overview of the current landscape and future prospects of CNS metastases care. The Special Issue will highlight innovative multimodality approaches and discuss the integration of cutting-edge clinical trials and diagnostic tools.

We welcome the submission of original research and insightful reviews that advance our understanding or refine the methodologies associated with the treatment of brain metastases. We welcome contributions that detail the emerging role of biomarkers, discuss the integration of AI in clinical settings, and review current medicines, radiation therapies, and surgical techniques that push the boundaries of what is currently possible in patient treatment and care.

This Special Issue is poised to be an essential resource for all stakeholders in neuro-oncology, from academic researchers to practicing clinicians, who are united in their goal of enhancing the outcomes for patients with brain metastases.

We look forward to your contributions and to advancing the field together.

Dr. Aristotelis Kalyvas
Guest Editor

Dr. Enrique Gutierrez-Valencia
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • brain metastases
  • targeted therapy
  • immunotherapy
  • artificial intelligence
  • neurosurgery
  • radiosurgery
  • biomarkers

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Published Papers (1 paper)

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Research

15 pages, 982 KiB  
Article
Surgical Resection Followed by Stereotactic Radiosurgery (S+SRS) Versus SRS Alone for Large Posterior Fossa Brain Metastases: A Comparative Analysis of Outcomes and Factors Guiding Treatment Modality Selection
by Ruth Lau, Enrique Gutierrez-Valencia, Anna Santiago, Carolyn Lai, Danyal Baber Ahmed, Parnian Habibi, Normand Laperriere, Tatiana Conrad, Barbara-Ann Millar, Mark Bernstein, Paul Kongkham, Gelareh Zadeh, David Benjamin Shultz and Aristotelis Kalyvas
Brain Sci. 2024, 14(11), 1059; https://doi.org/10.3390/brainsci14111059 - 25 Oct 2024
Viewed by 1132
Abstract
Background/Objectives: Around 20% of cancer patients will develop brain metastases (BrMs), with 15–25% occurring in the posterior fossa (PF). Although the effectiveness of systemic therapies is increasing, surgery followed by stereotactic radiosurgery (S+SRS) versus definitive SRS remains the mainstay of treatment. Given the [...] Read more.
Background/Objectives: Around 20% of cancer patients will develop brain metastases (BrMs), with 15–25% occurring in the posterior fossa (PF). Although the effectiveness of systemic therapies is increasing, surgery followed by stereotactic radiosurgery (S+SRS) versus definitive SRS remains the mainstay of treatment. Given the space restrictions within the PF, patients with BrMs in this location are at higher risk of brainstem compression, hydrocephalus, herniation, coma, and death. However, the criteria for treating large PF BrMs with S+SRS versus definitive SRS remains unclear. Methods: We reviewed a prospective registry database (2009 to 2020) and identified 64 patients with large PF BrMs (≥4 cc) treated with SRS or S+SRS. Clinical and radiological parameters were analyzed. The two endpoints were overall survival (OS) and local failure (LF). Results: Patients in the S+SRS group were more highly symptomatic than patients in the SRS group. Gait imbalance and intracranial pressure symptoms were 97% and 80%, and 47% and 35% for S+SRS and SRS, respectively. Radiologically, there were significant differences in the mean volume of the lesions [6.7 cm3 in SRS vs. 29.8 cm3 in the S+SRS cohort, (p < 0.001)]; compression of the fourth ventricle [47% in SRS vs. 96% in S+SRS cohort, (p < 0.001)]; and hydrocephalus [0% in SRS vs. 29% in S+SRS cohort, (p < 0.001)]. Patients treated with S+SRS had a higher Graded Prognostic Assessment (GPA). LF was 12 and 17 months for SRS and S+SRS, respectively. Moreover, the S+SRS group had improved OS (12 vs. 26 months, p = 0.001). Conclusions: A higher proportion of patients treated with S+SRS presented with hydrocephalus, fourth-ventricle compression, and larger lesion volumes. SRS-alone patients had a lower KPS, a lower GPA, and more brain metastases. S+SRS correlated with improved OS, suggesting that it should be seriously considered for patients with large PF-BrM. Full article
(This article belongs to the Special Issue Brain Metastases: Updates and Future Directions)
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