Metástasis Cerebrales

Yassir Ruiz Guardia

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Las metástasis cerebrales son la siembra de células neoplásicas en el parénquima cerebral y ocurrirán en 40% de los pacientes con cáncer y será responsable del 40% de las muertes.  En Panamá hubo 5432 casos nuevos de cáncer en 2009 y en Estados Unidos se reportan cerca de 200 mil casos anuales.  El 20% de los pacientes con cáncer debutan con síntomas neurológicos asociados.  El desarrollo de metástasis cerebrales no es una condición sine qua non de muerte inmediata y existen por lo menos 4 sistemas de clasificación pronóstica que toman en cuenta factores clínicos y de tratamiento, que se utilizan como herramientas para la elección del tratamiento óptimo.  Es necesario conocer los sitios primarios frecuentes, los mecanismos de patogenia, las modalidades óptimas para el diagnóstico temprano y los tratamientos médicos, quirúrgicos y oncológicos disponibles, los resultados y los efectos colaterales asociados para obtener un balance adecuado beneficio-complicaciones.  La Radioterapia en cualquiera de sus modalidades es el tratamiento pivote ya que los pacientes candidatos a cirugía comprenden solo un 10% del total.


Brain metastases


Brain metastases are the planting of neoplastic cells in the brain parenchyma and occur in 40% of patients with cancer and are responsible for 40% of deaths. In Panama there were 5432 new cases of cancer in 2009 and in the United States about 200 thousand cases a year are reported. 20% of cancer patients present with associated neurological symptoms. The development of brain metastases is not a sine qua non of immediate death and there are at least 4 prognostic classification systems that take into account clinical and treatment factors, which are used as tools for choosing the optimal treatment. You need to know the common primary sites, mechanisms of pathogenesis, optimal methods for early diagnosis and medical, surgical and oncological treatments available, the results and the side effects associated for proper assessment of the benefit-complications. Radiotherapy in all its forms is the pivot treatment because patients’ candidates for surgery comprise only 10% of the total.


Key Word: Metástasis cerebrales, células neoplásicas, cáncer, tratamientos oncológicos


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