Document Detail


Effectiveness of stereotactic radiosurgery alone or in combination with whole brain radiotherapy compared to conventional surgery and/or whole brain radiotherapy for the treatment of one or more brain metastases: a systematic review and meta-analysis.
MedLine Citation:
PMID:  16472924     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess the effectiveness of SRS alone or in combination with WBRT compared to surgery and/or WBRT in prolonging survival and improving the quality-of-life and functional status of patients with brain metastases. METHODS AND MATERIALS: A meta-analysis of randomized controlled trials and concurrent cohort studies examining SRS versus SRS + WBRT, SRS versus WBRT +/- surgical resection, SRS versus surgical resection only, or SRS + WBRT versus WBRT was conducted. Trial registers, bibliographic databases, and reference lists from selected studies and recent issues of relevant journals were searched. Neuro-oncology specialists were also contacted. All studies were analyzed independently by two reviewers, applying validated critical appraisal techniques. RESULTS: The review identified three RCTs and one cohort study. Among patients with multiple metastases, no difference in survival between those treated with WBRT + SRS and those treated with WBRT was found. However, in patients with one metastasis, a statistically significant difference, favoring those treated with WBRT + SRS, was observed. Regarding local tumor control at 24 months, rates were significantly higher in the WBRT + SRS treatment arm, regardless of the number of metastases. CONCLUSIONS: Adding SRS to WBRT improves survival in patients with one brain metastasis. Combining SRS and WBRT improves local tumour control and functional independence in all patients.
Authors:
Tania Stafinski; Gian S Jhangri; Elizabeth Yan; Devidas Menon
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Review     Date:  2006-02-10
Journal Detail:
Title:  Cancer treatment reviews     Volume:  32     ISSN:  0305-7372     ISO Abbreviation:  Cancer Treat. Rev.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-26     Completed Date:  2006-06-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7502030     Medline TA:  Cancer Treat Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  203-13     Citation Subset:  IM    
Affiliation:
Institute of Health Economics, 1200, 10405 Jasper Avenue, Edmonton, Alta., Canada T5J 3N4. tstafinski@ihe.ca
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MeSH Terms
Descriptor/Qualifier:
Brain Neoplasms / radiotherapy*,  secondary,  surgery*
Cohort Studies
Health Status
Humans
Quality of Life
Radiosurgery
Radiotherapy, Adjuvant
Randomized Controlled Trials as Topic
Selection Bias
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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