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- W2608654313 abstract "Introduction: In patients with one to three brain metastases and minimal extracranial disease, treatment of choice has traditionally been surgical resection followed by whole-brain radiotherapy (WBRT) or, alternatively, stereotactic radiosurgery (SRS) of the resection cavity. In this review, we sought to compare the efficacy of each post-operative radiation modality with respect to tumor recurrence and patient survival. Methods: Pubmed, Embase and Cochrane databases were searched through June 2016 for studies reporting outcomes of SRS or WBRT after metastasis resection. Studies were included if survival, progression-free survival or disease recurrence was reported for adults with systemic cancer and a brain metastasis resected before either SRS or WBRT. Comprehensive Meta-Analysis (CMA) software was used to calculate pooled effect estimates using fixed-effects and random-effect models for local recurrence, distant recurrence, and patient survival time. Results: Out of 9,098 studies, only 9 restrospective cohort studies with 776 patients (474 with WBRT versus 302 with SRS) satisfied inclusion criteria and were included in the final analysis. For local recurrence, the overall crude risk ratio of five studies comparing WBRT to SRS was 0.79 (95%-CI: 0.48-1.29, I2: 49.4%, p-heterogeneity=0.34). For distant recurrence, the overall risk ratio of four studies was 1.16 (95%-CI: 0.87-1.53, I2: 30.2%, p-heterogeneity = 0.23) comparing WBRT to SRS. Median survival time for patients treated with adjuvant WBRT ranged from 6.81 to 22.9 months versus 7 to 24 months for patients treated with SRS. One study reported an increased incidence of leukoencephalopathy following adjuvant WBRT, but increased radiation necrosis after adjuvant SRS. Conclusion: SRS of the resection cavity of brain metastases offers comparable survival and similar local and distant control as adjuvant WBRT. Future research on SRS should focus on achieving a better understanding of the various factors that may favour SRS over WBRT." @default.
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- W2608654313 date "2017-04-01" @default.
- W2608654313 modified "2023-09-27" @default.
- W2608654313 title "P14.22 Whole-Brain Radiotherapy versus Stereotactic Radiosurgery after Resection for Intracranial Metastasis: a systematic review and meta-analysis" @default.
- W2608654313 doi "https://doi.org/10.1093/neuonc/nox036.407" @default.
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