Rarely, a patient is found (either by symptoms or in a work-up of elevated serum tumor markers) to have central nervous system (CNS) recurrence.15
Recurrence that is limited to the CNS is potentially curable with resection and whole brain radia-tion,19,20,174 often with the addition of abbreviated chemotherapy.15,19,175
In contrast, patients experiencing CNS recurrence with simultaneous extracerebral disease activity have a very poor prognosis and can be salvaged only very rarely. Most investigators recommend that such patients should be treated only with palliative measures or in clinical trials.15,19,20,175
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