Treatment options of central nervous system malignacies – a review for medical oncologists

Tumors of the central nervous system are less common in adults. Most of these tumors are benign, only about one third of all tumors are malignant. Malignant tumors are usually of glial origin, about 80% of all CNS malignancies are glioma. With benign tumors, close follow up only is often sufficitent, with neurosurgical procedures upon progression or in certain locations. Malignant tumors of the CNS, however, always require a multimodal treatment approach with a cooperation of neurosurgery, radiotherapy, and medical oncology. Postoperative radiotherapy, unlike with other solid cancers, usually precedes systemic treatments. Stereotactic approaches – which include SRS (stereotactic radiosurgery), SRT (stereotactic radiotherapy) and gamma knife – are often considered treatment options. Prognosis of CNS malignancies is poor, survival of patients is rather short despite aggressive treatment approaches.