A Meta-Analysis Evaluating Whole-Brain Radiotherapy Combined with or without Stereotactic Radiotherapy for Patients with Brain Metastases

Objective In order to evaluate the efficacy of WBRT+SRT or WBRT alone for patients with brain metastases. Methods All qualified literatures about the WBRT combined with or without SRT were searched in every databases. RevMan 5.0 were used for this meta-analysis. Results After searching the databases and evaluating the articles, 9 studies including 25 415 patients were selected for meta analysis. The meta analysis results yielded an obvious difference between the WBRT+SRT group and WBRT group in overall survival with an HR=0.78（95%CI 0.70~0.87, P<0.000 1）, for the 1~3 metastases group HR=0.82（95%CI 0.70~0.95, P=0.009）, and the local control with an HR=0.3（95%CI 0.20~0.44,P<0.000 01）. The incidence rate of radiation toxicities （≥Grade 2） showed no significant difference between the two groups: for the acute toxicities with an OR=0.74（95%CI 0.45~1.21,P=0.23）, the late toxicities with an OR=1.25（95%CI 0.58~2.72, P=0.57）, and the total OR=0.86（95%CI 0.57~1.30,P=0.48）. Conclusion s WBRT combined with SRT is better than WBRT alone for patients with brain metastases in the OS and LC. WBRT combined with SRT would not lead more serious radiation toxicities than WBRT alone.