Bardia Hajikarimloo, Mohammad Amin Habibi, Ibrahim Mohammadzadeh, Salem M Tos, Ali Mortezaei, Saleh Behzadi, Parsa Lorestani, Kiarash Soltani, Mohammad Ali Nazari, Azin Ebrahimi, Mohammadamin Sabbagh Alvani
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引用次数: 0
Abstract
Background: Neoadjuvant stereotactic radiosurgery (SRS) has emerged as a novel therapeutic option in managing patients with brain metastasis (BM). Neoadjuvant SRS can address the current limitations of postoperative SRS through accurate lesion delineation and improved radiation dosimetry. This study evaluated the role of neoadjuvant SRS in patients with BM.
Methods: A comprehensive literature search was conducted. Studies that assessed the local control (LC), distant brain failure (DBF), leptomeningeal disease (LMD), overall survival (OS), and adverse radiation effects (ARE) rates in neoadjuvant SRS in BM were included.
Results: Ten studies involving 791 patients were included. The meta-analysis revealed a pooled 12- and 24-month LC rate of 91% (95% CI: 84%-96%) and 89% (95% CI: 81%-94%), respectively. The meta-analysis revealed 12- and 24-month DBF rates of 35% (95% CI: 31%-39%) and 44% (95% CI: 40%-47%), respectively. The meta-analysis exhibited a pooled 12- and 24-month LMD rate of 4% (95% CI: 2%-5%) and 5% (95% CI: 3%-7%), respectively. The meta-analysis showed a pooled 12- and 24-month ARE rate of 4% (95% CI: 3%-6%) and 5% (95% CI: 3%-7%), respectively. The meta-regression demonstrated that hypofractionated SRS (HF-SRS) was associated with a more favorable LC rate than single-fraction SRS (SF-SRS).
Conclusions: Neoadjuvant SRS is a promising option for BMs, offering favorable outcomes and a low toxicity profile. HF-SRS may be linked to a more favorable outcome than SF-SRS. Prospective randomized trials are necessary to compare neoadjuvant and postoperative SRS alongside evaluations of SF-SRS and HF-SRS.
期刊介绍：
Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving
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