Palliative care 2017

Algoritm for therapy of solitary brain metastasis at AUH

Solitary brain

metastasis

MRI scan

1. Good PS

2. Mass effect or

3. Neurol. deficit or

4. >3-4 cm

5. Unknown primary

Surgical

resection

Resect cavity

SRT

1. Good PS

2. No mass effect

3. No neurol. deficit

4. <3-4 cm

SRT

Poor performance

status

(or do not fit into two

other arms)

WBRT or

steroids

Addtional factors:

• Age

• Performance status

• Metastasis localization

• Patient’s preferences

• Highly chemosensitive

cancers with brain mets

should be treated with

chemotherapy