The evolution of radiotherapy technologies in the special treatment of malignant tumor metastases in the brain (a brief overview)

Currently, brain metastases are the main cause of death in patients with metastatic cancer. Despite the use of modern systemic anticancer therapy and improvement of the overall survival of patients, the number of patients with metastases of various malignant neoplasms in the brain continues to increase. Due to the development of new antitumor technologies and modern methods of special treatment, the paradigm of treatment of brain metastases has been developing very rapidly over the past 30 years. For example, previously brain metastases had been considered the terminal stage of cancer, and life expectancy was only 1 month. However, already in the 1980s of the last century, the use of radiotherapy of the entire brain in patients with brain metastases increased life expectancy to 4-6 months. The standard method of treatment of this category of neuro-oncological patients was determined, accompanied by a fairly good efficiency and consisting in the use of adjuvant radiotherapy of the entire brain after surgical resection of single metastases.Subsequently, due to the development of stereotactic radiotherapy / radiosurgery, including their possible combination with radiotherapy of the entire brain, satisfactory survival results were shown in patients, in particular, with single brain metastases, with very good preservation of neurocognitive functions. In addition, stereotactic radiosurgery in combination with radiotherapy of the entire brain, as well as proton therapy, can also be promising methods of special treatment for patients with multiple brain metastases who cannot be treated surgically.