Abstract:
Stereotactic radiosurgery is frequently used either alone or together with whole brain radiotherapy to treat brain metastases. Some studies reported better results with combination of WBRT+SRS, while others reported that WBRT didn’t enhance the effect of SRS.
The aim of this meta-analysis is to determine whether WBRT+SRS or SRS alone will result in better clinical outcomes for patients with brain metastases .
The meta-analyses were done using an online effect size calculator -based on the reference(practical meta-analysis) by David.B Wilson- on the following outcomes : survival rate, local tumor recurrence rate, new distant brain metastases recurrence rate, and the neuorologic radiation toxicity rate .
It is found that : the local tumor recurrence and the new distant brain metastases recurrence rates had been reduced in the WBRT+SRS group with Odds Ratios of 0.36 and 0.44 respectively; but the neuorologic radiation toxicity rate was higer in the WBRT+SRS group with an Odds Ratio of 3.84 . And there was no significant difference in one year survival rate between the two groups with an Odds Ratio of 0.54 .
It is concluded that: the WBRT reduces the local tumor recurrence and new brain metastases recurrence; but worsens the neuorocognitive function in the patients. On other hand, the addition of WBRT to SRS didn’t improve the survival for patients with brain metastases.
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