Treatment group | Age in years | Proportion of patients |
||||
---|---|---|---|---|---|---|
Males | Asymptomatic | With single brain metastasis | With controlled primary disease | |||
Median | 53.0 | 63.8% | 26.6% | 29.0% | ||
WBRT alone | IQR | 49.0–55.8 | 42.5–73.7 % | NA | 18.5–48.6% | 13.9–47.8% |
N studies(pts) | 10 (295) | 13 (496) | 2 (85) | 7 (339) | 10 (329) | |
Median | 60.2 | 66.7% | 66.8% | 54.8% | 32.2% | |
SRS alone | IQR | 56.25–62.25 | 54.0–76.3% | 59.65–78.79% | 41.19–61.22 | 26.16–36.32% |
N studies(pts) | 9 (444) | 12 (822) | 4 (359) | 9 (706) | 8 (669) | |
WBRT and any of SRS, surgery, | Median | 53.0 | 63.4% | 51.7% | 45.9% | |
IQR | 47.00–58.75 | 51.64–73.88% | 40.72–72.91% | 30.18–68.06% | ||
chemotherapy, non-contemp | N studies(pts) | 5 (243) | 6 (266) | 4 (223) | 6 (262) | |
SRS and any of; | Median | 56.9 | 59.1% | 65.4% | 38.8% | 24.0% |
surgery, WBRT, chemotherapy, | IQR | 52.5 – 59.25 | 54.82 – 68.04% | 51.28 – 66.38% | 30.11 – 51.74% | 17.56 – 39.70% |
non-contemp | N studies(pts) | 17 (1127) | 20 (1838) | 5 (953) | 16 (1697) | 16 (1660) |
Treatment | Groups | Median survival | 1-year survival rate, % | 1-year local control rate | 6-mo new brain lesion rate | Serious adverse events | ||||
---|---|---|---|---|---|---|---|---|---|---|
Studies (Patients) | Months (IQR) | Studies (Patients) | % (IQR) | Studies (Patients) | % (IQR) | Studies (Patients) | % (IQR) | |||
Non-random, | WBRT | 11 (980) | 4.0 (3.0, 4.0) | Not reported | ||||||
comparative | WBRT+Surg | 11 (439) | 11.0 (8.8,11.8) | |||||||
All studies | WBRT | 26 (2185) | 3.5 (2.4, 4.0) | 7 (189) | 9.0 (0.0, 22.5) | 1 (74) | 5.5 (0.0, | Post-op death; | ||
WBRT+Surg | 16 (619) | 11.0 (7.8, 12.0) | 1 (19) | 0 | 12.0) | 2% (1 study), | ||||
Hemorrhage; | ||||||||||
3/72 lesions (1 Study) | ||||||||||
Non-random, | WBRT | 5 (699) | 3.9 (3.6, 5.0) | - | ||||||
comparative | Surgery | 5 (234) | 9.8 (7.6, 16.5) | Gr3 tox; 3/39 (1 study) | ||||||
Surgery | 9 (359 | 8.7 (6.2, 10.4) | 1 (16) | Post-op death; | ||||||
All studies | 2% (1 Study) | |||||||||
Non-random, | WBRT | 3 (931) | 4.1 (3.2, 5.6) | - | ||||||
comparative | SRS | 3 (980) | 8.8 (7.2, 11.4) | Hemorrhage; 4/56 | ||||||
SRS | 8 (1188) | 7.5 (6.7, 9.0) | 6 (330) | 35.5 (20.8, 47.8) | 4 (260) | 76.0 | lesions (1 study) | |||
All studies | (62.8, | (SRS-GK) | ||||||||
88.5) | ||||||||||
SRS-GK | 5 (208) | 7.0 (5.6, 7.8) | 1 (83) | |||||||
SRS Type | SRS-LA | 0 | - | |||||||
SRS-NS | 3 (980) | 8.8 (7.2, 11.4) | ||||||||
Non-random, | WBRT | 4 (148) | 2.5 (1.0, 4.2) | 0 | Gr3 tox; 3/39 (1 study) | |||||
comparative | WBRT +Chemo | 4 (62) | 5.5 (4.0, 6.0) | 1 (7) | ||||||
Leukopenia; 2/8 | ||||||||||
All studies | WBRT+Chemo | 6 (137) | 4.3 (2.8, 6.0) | 2 (15) | 0 | - | 0 | - | (1 study), Toxicity; | |
9/14 (1 study) | ||||||||||
Swelling | ||||||||||
Non-random, | SRS | 5 (881) | 7.0 (6.0, 8.1) | 1 (83) | requiring surgical | |||||
comparative | WBRT+SRS | 5 (344) | 6.5 (5.7, 6.5) | 1 (39) | decompression; | |||||
3/77 pts (1 study) | ||||||||||
WBRT+SRS | 12 (516) | 7.0 (6.0, 8.0) | 3 (58) | 36.0 (29.5, 37.0) | 0 | - | 0 | - | ||
All studies | - | |||||||||
Non-random, | WBRT | 4 (337) | 3.6 (2.7, 5.0) | 1 (59) | ||||||
comparative | WBRT+SRS | 4 (197) | 7.4 (6.5, 10.7) | 1 (8) | ||||||
Al studies | SRS+Chemo | 1 (23) | 0 | - | 0 | - | 0 | - | - | |
SRS+/- Chemo | 7 (580) | 2 (358) | 1 (106) | 1 (106) | Hemorrhage; 1/106 pt (1 study), 4/56 lesions (1 study). Radiation necrosis; 1/106 pts (1 study) | |||||
All studies | SRS+Surg | 4 (200) | 13 (9.4, 13.5) | 1 (60) | 1 (34) | 1 (34) | Hemorrhage; | |||
18% (1 study) | ||||||||||
All studies | WBRT and any of | 47 (2230) | 7.2 (4.6, 9.4) | 19 (827) | 21.4 (13.6, 37.0) | 5 (208) | 1.0 (0.0, | 8 (986) | 46.5 (39.8, | WBRT specific; |
surgery, SRS, non- | 16.0) | 55.5) | Deaths;6/194 | |||||||
contemp | (1 study), headache; 12/26 (1 study), Toxicity > Gr3; 3/7 (1 study) LeukopeniaGr1-2; 2/9 (1 study) Hemorrhage; 1/20 (1 study) | |||||||||
All studies | SRS and any of | 42 (2702) | 8.0 (6.2, 10.9) | 35 (2644) | 31.0 (25.0, 39.0) | 16 (1043) | 69.0 | 10 (1261) | 49.0 (42.0, | SRS specific; |
surgery, WBRT, non- | (60.0, | 56.0) | Hemorrhage; 14% | |||||||
contemp | 82.0) | (4 studies, 441 patients) Radiation necrosis; 6.6% (4 studies, 241 patients Seizure-edema-death; 1/55 (1 study) Complications; 6/106 (1 study) |
Reference | Year | Country | Treated years | Total patients | Prospective data | Design | Surgery | WBRT | SRS |
Non-contemp | |
---|---|---|---|---|---|---|---|---|---|---|---|
LA | GK | ||||||||||
Carella |
1980 | US | 1971–NS | 60 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Katz |
1981 | US | 1971–1980 | 63 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Vlock |
1982 | US | 1970–1980 | 46 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Byrne |
1983 | US | 1978–1980 | 80 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Stridsklev |
1984 | Norway | 1973–1980 | 39 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Choi (A) |
1985 | US | 1972–1977 | 194 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Choi (B) |
1985 | US | 1972–1977 | 59 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Ziegler |
1986 | US | 1972–1984 | 72 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Rate |
1988 | US | 1980–1987 | 77 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Hagen |
1990 | US | 1972–1987 | 35 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Stevens |
1992 | Australia | 1982–1990 | 129 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Somaza |
1993 | US | 1988–1992 | 23 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Willner |
1995 | Germany | 1985–1993 | 30 | ⨯ | Disease cohort | ✓ | ✓ | ✓ | ||
Isokangas |
1996 | Finland | 1980–1994 | 60 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Skibber |
1996 | US | 1979–1991 | 34 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Gieger |
1997 | US | 1992–1994 | 12 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Gupta |
1997 | UK | 1991–1996 | 31 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Grob |
1998 | France | 1993–1996 | 35 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Sampson |
1998 | US | past years 20 | 670 | ⨯ | Disease cohort | ✓ | ✓ | |||
Seung |
1998 | US | 1991–1995 | 55 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Lavine |
1999 | US | 1994–1997 | 45 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Kontsadoulakis |
2000 | US | 1970–1992 | 136 | ⨯ | Disease cohort | ✓ | ✓ | ✓ | ||
Ellerhorst |
2001 | US | 1992–1995 | 87 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Buchsbaum |
2002 | US | 1994–1998 | 74 | ⨯ | Disease cohort | ✓ | ✓ | ✓ | ✓ | |
Gonzalez- Martinez |
2002 | US | 1996–NS | 24 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Mingione |
2002 | US | 1989–1999 | 45 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Noel |
2002 | France | 1994–2001 | 25 | ⨯ | Treatment cohort | ✓ | ||||
Yu |
2002 | US | 1994–1999 | 122 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Zacest |
2002 | Australia | 1979–1999 | 147 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Harrison |
2003 | US | 1990–1997 | 65 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Conill |
2004 | Spain | 1997–2002 | 26 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Fife |
2004 | Australia | 1985–2000 (also 1952– 1984) | 686 (+ 451) | ⨯ | Disease cohort | ✓ | ✓ | |||
Meier |
2004 | Switzerland | 1966–2002 | 100 | ⨯ | Disease cohort | ✓ | ✓ | ✓ | ✓ | ✓ |
Morris |
2004 | UK | 1998–2003 | 102 | ⨯ | Treatment cohort | ✓ | ✓ | ? | ? | ✓ |
Radbill |
2004 | US | 1996–2001 | 51 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Selek |
2004 | US | 1991–2001 | 103 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Stone |
2004 | US | 1989–1999 | 83 | ⨯ | Disease cohort | ✓ | ✓ | ✓ | ||
Koc |
2005 | US | 1999–2003 | 26 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Panagiotou |
2005 | Greece | 1986–2001 | 64 | ⨯ | Disease cohort | ✓ | ✓ | ✓ | ||
Rhomberg |
2005 | Austria | 1982–2002 | 19 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Christopoulou |
2006 | UK | 1998–2004 | 29 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
MarquestaGaudy- |
2006 | France | 1997–2003 | 106 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Conill |
2007 | Spain | 1997–2004 | 37 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Mathieu |
2007 | US | 1987–2005 | 245 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Samlowski |
2007 | US | 1999–2004 | 44 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Raizer |
2008 | US | 1991–2001 | 355 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | ✓ |
Redmond |
2008 | US | 1998–2007 | 59 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Carrubba |
2009 | US | 2002–2007 | 37 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | |
Ahmad |
2010 | UK | 2001–2009 | 65 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Rades |
2010 | Germany | 1989–2008 | 51 | ⨯ | Treatment cohort | ✓ | ||||
Schild |
2010 | US | NS | 7 (+ 53) | Y+N | Treatment cohort | ✓ | ✓ | |||
Staudt |
2010 | Germany | 1986–2003 | 265 | ⨯ | Disease cohort | ✓ | ✓ | ✓ | ✓ | |
Davies |
2011 | US | 1986–2004 | 330 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | |
Eigentler |
2011 | Germany | 1986–2007 | 672 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | ✓ |
Liew |
2011 | US | 1987–2008 | 333 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Skeie |
2011 | Norway | 1996–2006 | 77 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Zakrzewski |
2011 | US | 2002–2008 | 89 | ⨯ | Disease cohort | ✓ | ? | ? | ✓ | |
Bernard |
2012 | US | 2004–2010 | 54 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Hauswald |
2012 | Germany | 2000–2011 | 87 | ⨯ | Treatment cohort | ✓ | ✓ | ? | ? | |
Knisely |
2012 | US | 2002–2010 | 77 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Koay |
2012 | US | 2005–2011 | 296 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | ✓ |
Lo |
2012 | US | 2000–2007 | 28 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Salvati |
2012 | Italy | 1997–2007 | 84 | ⨯ | Treatment cohort | ✓ | ✓ | ? | ? | |
Mathew |
2013 | US | 2008–2011 | 58 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Miller |
2013 | Germany | 2000–2010 | 34 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Partl |
2013 | Austria | 1988–2009 | 87 | ⨯ | Treatment cohort | ✓ | ✓ | ? | ? | |
Silk |
2013 | US | 2005–2012 | 70 | ⨯ | Treatment cohort | ✓ | ? | ? | ✓ | |
Zukauskaite |
2013 | Denmark | 1995–2009 | 80 | ⨯ | Treatment cohort | ✓ | ✓ | ? | ? | ✓ |
Dyer |
2014 | US | 2000–2010 | 147 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Marcus |
2014 | US | 1998–2010 | 135 | ⨯ | Treatment cohort | ✓ | ✓ | ? | ? | ✓ |
Neal |
2014 | US | 2000–2009 | 129 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Rades |
2014 | Germany | 2000–2013 | 54 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Vecchio |
2014 | Italy | 1994–2010 | 115 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | ✓ |
Christ |
2015 | US | 2005–2011 | 103 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Frakes |
2015 | US | 2008–2012 | 28 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Hauswald |
2015 | Germany | 1990–2011 | 84 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Ivanov |
2015 | Russia | 2009–2013 | 95 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Ly |
2015 | US | 2009–2012 | 52 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Ostheimer |
2015 | Germany | 1992–2011 | 100 | ⨯ | Treatment cohort | ✓ | ✓ | ? | ? | ✓ |
Gallaher |
2016 | US | since 2006 | 19 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Gupta |
2016 | UK | NS | 18 | Yes | RCT | ✓ | ✓ | |||
Patel |
2016 | US | 2007–2014 says (abstract 2005– 2013) | 87 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Rades |
2016 | Germany | 2000–2015 | 23 | ⨯ | Treatment cohort | ✓ | ||||
Szyszka-Chare |
2016 | Poland | 1985–2012 | 110 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | ✓ |
Wolf |
2016 | US | 2012–2015 | 80 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Acharya |
2017 | US | 2006–2016 | 72 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
All |
2017 | US | 2008–2016 | 58 | ⨯ | Treatment cohort | ? | ? | |||
Feng |
2017 | US | 2007–2014 | 87 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | ✓ |
Kaidar-Person |
2017 | US | 2007–2015 | 58 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Minniti |
2017 | Italy | 2008–2015 | 120 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Patel |
2017 | US | 2009–2013 | 54 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Pessina |
2017 | Italy | 2011–2015 | 53 | ⨯ | Treatment cohort | ✓ | ? | ? | ||
Sperduto |
2017 | US | 2006–2013 | 823/481 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | |
Xu |
2017 | US | 2010–2014 | 65 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Diao(A) |
2018 | US | 2006–2015 | 72 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Diao(B) |
2018 | US | 2006–2015 | 91 | ⨯ | Treatment cohort | ✓ | ✓ | |||
Fang |
2018 | US | 2005–2011 | 235 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | ✓ |
Gabani |
2018 | US | 2011–2013 | 1104 | ⨯ | Treatment cohort | ✓ | ? | ? | ✓ | |
Kano |
2018 | US | 1988–2012 | 422 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Kotecha |
2018 | US | 1987–2014 | 366 | ⨯ | Disease cohort | ✓ | ✓ | ✓ | ✓ | ✓ |
Ladwa |
2018 | Australia | 2009–2016 | 142 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | |
Matsunaga |
2018 | Japan | 1991–2015 | 177 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Tio |
2018 | Australia | 2011–2014 | 355 | ⨯ | Disease cohort | ✓ | ✓ | ? | ? | ✓ |
Zubatkina |
2018 | Russia | 2009–2014 | 78 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ||
Hauswald |
2019 | Germany | 2013–2017 | 7 | Yes | RCT | ✓ | ||||
Hong |
2019 | Australia | 2009–2017 | 215 | Yes | RCT | ✓ | ✓ | ? | ? | ✓ |
Jardim |
2019 | Australia | 2015–2017 | 43 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Mastorakos |
2019 | US | 2011–2015 | 198 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | |
Phillips |
2019 | Canada | 2000–2018 | 277 | NS | Disease cohort | ✓ | ? | ? | ||
Tjong |
2019 | Canada | 2008–2017 | 97 | ⨯ | Treatment cohort | ✓ | ✓ | ? | ? | |
McHugh |
2020 | Zealand New | 2005–2017 | 110 | ⨯ | Treatment cohort | ✓ | ✓ | ? | ? | ✓ |
Pomeranz- Krumme |
2020 | US | 2010–2018 | 25 | ⨯ | Treatment cohort | ✓ | ✓ | ✓ | ✓ | ✓ |
First year of recruitment | Pre–1989 | 1990–2002 | 2003–2015 | Not reported | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
No. of studies | Median survival | IQR | No. of studies | Median survival | IQR | No. of studies | Median survival | IQR | No. of studies | Median survival | IQR | |
All patients | 25 | 4.8 | 3.25–8.05 | 33 | 6.0 | 4.35–8.00 | 22 | 9.2 | 6.90–11.43 | 1 | NA | |
WBRT alone | 17 | 3.6 | 2.49–4.0 | 7 | 2.5 | 2.3–4.0 | 6 | 4.2 | 2.75–4.80 | 3 | 4.3 | 3.40–6.40 |
SRS alone | 2 | 4 | 7.3 | 5.78–7.88 | 2 | 0 | ||||||
WBRT and any of surgery, SRS, non-contemporary systemic therapy | 43 | 7.4 | 4.00–9.20 | 23 | 7.3 | 5.50–10.00 | 4 | 8.0 | 5.73–10.50 | 2 | ||
SRS and any of surgery, WBRT, non-contemporary systemic therapy | 17 | 8.3 | 5.90–9.65 | 29 | 7.9 | 5.85–10.04 | 18 | 9.0 | 6.90-13.00 | 0 |