Central Nervous System Metastasis, the Biological Basis and Clinical Considerations (Cancer Metastasis - Biology and Treatment Book 18)

This volume will cover what is known regarding the biology and treatment of CNS metastasis, including novel chapters such as the future of targeted therapies. It will begin with an overview of the natural history and risk factors for CNS metastases that will broadly cover all cancer histologies. This will be followed by 3 chapters that will cover the biology. These include: molecular biology, discussing what is known about specific genes/proteins involved in the process and model systems to study brain metastasis; the brain microenvironment, focusing on how it is different from the microenvironment of other organs of the body; and the blood-brain barrier, which includes a discussion of permeability with respect to brain metastases. A chapter on experimental imaging will cover both the biology of brain metastasis from an imaging perspective and use of imaging techniques to study brain metastases. The clinical chapters will discuss treatment options with separate chapters on surgery, chemotherapy and radiation. In addition, leptomeningeal metastasis will be given its own chapter. Finally, quality of life issues will be the concluding chapter. This volume covers what is known regarding the natural history, basic biology, and clinical aspects, including imaging and treatment, of CNS metastasis. Three chapters cover the biology of the brain and brain metastases: molecular biology, includes what is known about specific genes/proteins involved in the process of metastasis and model systems to study brain metastasis; brain microenvironment, focuses on the resident cells of the microenvironment and their role in CNS metastasis; and the blood-brain barrier, includes a discussion of permeability with respect to brain metastases. A discussion of experimental imaging covers both the biology of brain metastasis from an imaging perspective and the use of imaging techniques to study brain metastases. The three clinical chapters discuss treatment options of surgery, chemotherapy, and radiation. The potential for novel targeted therapies is also addressed. Because of the uniqueness of the disease, leptomeningeal metastasis is discussed separately. The last chapter is devoted to quality of life issues associated with CNS metastasis Front Matter....Pages i-xi An Introduction to Brain Metastasis....Pages 1-13 The Molecular Biology of Brain Metastasis....Pages 15-41 The Brain Microenvironment....Pages 43-54 Vascular Permeability Within Brain Metastases....Pages 55-68 Imaging Experimental Brain Metastases....Pages 69-86 Possibilities of Targeted Therapies for Brain Metastasis....Pages 87-107 Surgery for Brain Metastasis....Pages 109-132 Is There a Role for Systemic Chemotherapy in the Treatment of Brain Metastases?....Pages 133-151 Radiation Therapy of CNS Metastases....Pages 153-186 Leptomeningeal Metastasis....Pages 187-200 Quality of Life with CNS Metastasis....Pages 201-219 Back Matter....Pages 221-226 Here is a thorough survey of the biology and treatment of CNS metastasis, including natural history, risk factors, molecular biology, the blood-brain barrier, imaging, quality of life, surgery, chemotherapy, radiation and the future of targeted therapies.