Intracranial Metastases: Current Management Strategies

This title aims to fill the gap. Intracranial Metastases is a multiauthored text by some of the best experts working in each of the subject areas covered. The text is usefully divided into four main sections. In the first section the biology, pathology, epidemiology, and neuroimaging of intracranial metastases are illustrated and thoroughly discussed. Of particular note is the first chapter on the history of treatment for intracranial metastases. In the second section the different treatment options are analysed. New treatments are brought into focus, especially those not used by most physicians who routinely treat patients with intracranial metastases (ie, the treatment of intracranial multiple metastases). The third section—of most interest for the treating physician—describes the metastatic disease in relation to the primary cancer. As a matter of fact, the clinical course of intracerebral metastasis is determined, even if only temporarily, by the type of primary tumour. Of particular interest is the chapter on leptomeningeal localisation, which is a common cause of controversy in the management and treatment of intracranial metastases. In the last section, metastasis localised in the cranial base and the neuropsychological features of the disease are explained together with a clear-cut conclusion of the text on management guidelines and decision-making. In brief, the publication of this book is long overdue, and Intracranial Metastases should be considered a reference text for family physicians, neurologists, neurosurgeons, oncologists, and radiotherapists. It is concise but exhaustive. This manual has all the essential information for a correct management and therapy of this pathology. If there is one pitfall to this summary, I would say that the bibliography is not always accurately updated. This publication clearly delineates which patients should be treated and for how long, and will be important in helping physicians to avoid the overtreatment of patients. Furthermore, this book may encourage treating physicians to increase the number of patients they treat. Some of these patients will benefit from a few more months of good quality of life and some others who have germinal metastasis may even be cured. I personally like the short summaries at the end of each chapter, which bring into focus what has been read before and give a concise precis of the argument. The editor has nicely coordinated a board of experienced authors who have excellently used the knowledge and experience that they have acquired in their professional lives.

Maurizio Salvati