Evidence based management options for patients with intracranial metastases

Incidence The incidence of cerebral metastases is variably reported with 14.3 per 100,000 per annum in a Scottish population study. Overall, a third of patients with cancer develop intracranial metastases. The commonest primary tumours arise from the lung and breast. Melanomas, renal cell carcinomas and gastrointestinal tract malignancies account for most of the remainder (Table 1). MRI and post-mortem studies indicate that at least 50% of patients have multiple lesions. Around 80% of intracranial metastases are supratentorial and 20% occur in the posterior fossa.