The role of preoperative stereotactic radiotherapy in the management of resectable brain metastases: A systematic review.

IF 2.5 3区医学 Q3 ONCOLOGY

Strahlentherapie und Onkologie Pub Date : 2025-09-26 DOI:10.1007/s00066-025-02475-z

Sasha Benichou, Nicolas Giraud, Julien Engelhardt, Hélène Cebula, Julian Biau, Georges Noel, Philippe Giraud

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引用次数: 0

Abstract

Objectives: This systematic review assessed the efficacy and safety of preoperative stereotactic radiotherapy (PreopSRT) in the treatment of resectable brain metastases (BM).

Methods: A PRISMA systematic review was conducted using Web of Science, Scopus, and PubMed. The search terms included "(brain or cerebral) and (metastasis or metastases) and (radiotherapy or radiosurgery or radiation) and (neoadjuvant or preoperative)." Of the 2061 articles identified, 12 studies met the inclusion criteria: patients with resectable BM who received PreopSRT in single or multiple fractions. Literature reviews, protocols, and studies on salvage resections were excluded.

Results: Local control at 6 months ranged from 81.8 to 100%, with over 95% control reported in 4 studies, reaching 100% in 3 series. At 12 months, local control ranged from 49.1 to 95%. Data for 24-month local control were available for only 3 studies, ranging from 73 to 97.1%. Multiple fractions appeared to be more effective. PreopSRT showed a rate of leptomeningeal recurrence between 0 and 17% and a rate of radionecrosis from 3.5 to 10.5% at 1 year.

Conclusion: This PRISMA review highlights the growing interest in preoperative stereotactic radiotherapy, which appears at least as effective and potentially less toxic than postoperative treatment. Phase III trials are needed to confirm its clinical use.

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术前立体定向放疗在可切除脑转移瘤治疗中的作用：一项系统综述。

目的：本系统评价术前立体定向放疗（PreopSRT）治疗可切除脑转移瘤（BM）的疗效和安全性。方法：使用Web of Science、Scopus和PubMed进行PRISMA系统评价。搜索词包括“（脑或脑）、（转移或转移）、（放疗或放射外科或放疗）和（新辅助或术前）”。在确定的2061篇文章中，12篇研究符合纳入标准：可切除BM患者接受单个或多个部分的PreopSRT。文献综述、方案和打捞性切除的研究被排除在外。结果：6个月局部控制率从81.8%到100%不等，4个研究报告控制率超过95%，3个系列达到100%。12个月时，局部控制率为49.1%至95%。只有3项研究的24个月局部对照数据，范围从73%到97.1%。多重分数似乎更有效。术前srt显示，1年的轻脑膜复发率为0% ~ 17%，放射性坏死率为3.5% ~ 10.5%。结论：本次PRISMA综述强调了术前立体定向放疗日益增长的兴趣，其至少与术后治疗一样有效，而且潜在的毒性更小。需要三期试验来确认其临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Strahlentherapie und Onkologie 医学-核医学

CiteScore

5.70

自引率

12.90%

发文量

141

审稿时长

3-8 weeks

期刊介绍： Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research. Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.