Management of brain metastases: past, present, and future.

Brain metastasis is an important cause of morbidity and mortality in cancer patients. Because most of these patients die of systemic disease, the primary therapeutic goal is to improve the quality of life. Conventional therapy for brain metastases is usually whole-brain irradiation. Chemotherapy often results in regression of brain metastases in chemosensitive tumors. We review our institutional experience in the treatment of brain metastasis with both radiation and chemotherapy. In the future, improvement in the management of brain metastases will depend on improved chemotherapy, radiosensitizers, and radiotherapy techniques such as stereotactic radiosurgery.