Scholarlink

Background <p>Whole-brain radiotherapy (WBRT) has traditionally been the primary treatment for most patients with brain metastases despite its adverse effects on overall health. Recently, stereotactic radiosurgery (SRS) has emerged as a safe and effective alternative. However, the data comparing the efficacy and safety of SRS and WBRT remain inconsistent. To address this, we conducted a systematic review and meta-analysis to synthesize evidence from all published studies comparing SRS and WBRT for patients with brain metastases.</p> Methods <p>We systematically searched electronic databases, including PubMed, Scopus, Web of Science, and Cochrane CENTRAL, to identify relevant comparative studies on stereotactic radiosurgery and whole-brain radiotherapy for brain metastases. Eligible studies were selected based on predefined criteria, and data were extracted using a standardized data extraction sheet. RevMan software (version 5.2) was used to perform meta-analysis and generate forest plots.</p> Results <p>This meta-analysis included 35 studies (27 observational and 8 RCTs), encompassing a total of 26,000 patients. SRS was linked to longer survival times (mean difference of 4.38 months, 95% CI [3.10, 6.57], <i>P</i> &lt; 0.00001); however, this was predominantly influenced by retrospective studies, with evidence from two RCTs indicating similar survival times. SRS also resulted in a longer time to intracranial progression (standardized mean difference of -0.94, 95% CI [-1.64, -0.23], <i>P</i> = 0.009) and improved local intracranial control (risk ratio of 1.20, 95% CI [1.01, 1.42], <i>P</i> = 0.04). No significant difference was observed between SRS and WBRT regarding distant intracranial control (odds ratio of 0.61, 95% CI [0.32, 1.19], <i>P</i> = 0.15). A systematic collection of data related to adverse events was done.</p> Conclusion <p>SRS enhances survival and local tumor control but is associated with an increased risk of distant brain recurrences. Due to its safety profile, SRS is recommended for high-risk patients, as it preserves short-term quality of life and maintains long-term cognitive function.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Efficacy and safety of stereotactic radiosurgery versus whole brain radiotherapy for the treatment of brain metastasis: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年10月29日

查看全文
  • Shrouk F. Mohamed,
  • Emad D. Singer,
  • Abdelrahman Youssef,
  • Hebatalla M. Farouk,
  • Mohamed Elmallahy,
  • Hazem S. Ghaith,
  • Ahmed Negida,
  • Amr Moursi

摘要

Background

Whole-brain radiotherapy (WBRT) has traditionally been the primary treatment for most patients with brain metastases despite its adverse effects on overall health. Recently, stereotactic radiosurgery (SRS) has emerged as a safe and effective alternative. However, the data comparing the efficacy and safety of SRS and WBRT remain inconsistent. To address this, we conducted a systematic review and meta-analysis to synthesize evidence from all published studies comparing SRS and WBRT for patients with brain metastases.

Methods

We systematically searched electronic databases, including PubMed, Scopus, Web of Science, and Cochrane CENTRAL, to identify relevant comparative studies on stereotactic radiosurgery and whole-brain radiotherapy for brain metastases. Eligible studies were selected based on predefined criteria, and data were extracted using a standardized data extraction sheet. RevMan software (version 5.2) was used to perform meta-analysis and generate forest plots.

Results

This meta-analysis included 35 studies (27 observational and 8 RCTs), encompassing a total of 26,000 patients. SRS was linked to longer survival times (mean difference of 4.38 months, 95% CI [3.10, 6.57], P < 0.00001); however, this was predominantly influenced by retrospective studies, with evidence from two RCTs indicating similar survival times. SRS also resulted in a longer time to intracranial progression (standardized mean difference of -0.94, 95% CI [-1.64, -0.23], P = 0.009) and improved local intracranial control (risk ratio of 1.20, 95% CI [1.01, 1.42], P = 0.04). No significant difference was observed between SRS and WBRT regarding distant intracranial control (odds ratio of 0.61, 95% CI [0.32, 1.19], P = 0.15). A systematic collection of data related to adverse events was done.

Conclusion

SRS enhances survival and local tumor control but is associated with an increased risk of distant brain recurrences. Due to its safety profile, SRS is recommended for high-risk patients, as it preserves short-term quality of life and maintains long-term cognitive function.