Whole Brain Radiotherapy Combined with Stereotactic Radiotherapy Versus Stereotactic Radiotherapy Alone for Brain Metastases: a Meta-analysis

Aim: This study was to evaluate the effect of whole brain radiation (WBRT) combined with stereotacticradiotherapy (SRS) versus stereotactic radiotherapy alone for patients with brain metastases using a metaanalysis.Materials and
Methods: We searched PubMed, EMBASE, Cochrane Library from their inceptionup to October 2013. Randomized controlled trials involving whole brain radiation combined with stereotacticradiotherapy versus stereotactic radiotherapy alone for brain metastases were included. Statistical analyseswere performed using RevMan5.2 software.
Results: Four randomized controlled trials including 903 patientswere included. The meta-analysis showed statistically significant lowering of the local recurrence rate (OR=0.29,95%CI: 0.17~0.49), new brain metastasis rate (OR=0.45, 95%CI: 0.28~0.71) and symptomatic late neurologicradiation toxicity rate (OR=3.92, 95%CI: 1.37~11.20) in the combined group. No statistically significant differenceexisted in the 1-year survival rate (OR=0.78, 95%CI: 0.60~1.03).
Conclusions: The results indicate that wholebrain radiotherapy combined with stereotactic radiotherapy has advantages in local recurrence and new brainmetastasis rates, but stereotactic radiotherapy alone is associated with better neurological function. However, asthe samples included were not large, more high-quality, large-sample size studies are necessary for confirmation.