Introduction: Local failure (LF) following stereotactic radiosurgery (SRS) of brain metastases (BM) may be treated with a second course of SRS (SRS2), though this procedure may increase the risk of symptomatic radionecrosis (RN). Methods: A literature search was conducted according to PRISMA to identify studies reporting LF, overall survival (OS) and RN rates following SRS2. Meta-analysis was performed to identify predictors of RN. Results: Analysis included 11 studies (335 patients,389 metastases). Pooled 1-year LF was 24 %(CI95 % 19–30 %): heterogeneity was acceptable (I2 = 21.4 %). Median pooled OS was 14 months (Confidence Interval 95 %, CI95 % 8.8–22.0 months). Cumulative crude RN rate was 13 % (95 %CI 8 %–19 %), with acceptable heterogeneity (I2 = 40.3 %). Subgroup analysis showed higher RN incidence in studies with median patient age ≥59 years (13 % [95 %CI 8 %–19 %] vs 7 %[95 %CI 3 %–12 %], p = 0.004) and lower incidence following prior Whole Brain Radiotherapy (WBRT, 19 %[95 %CI 13 %–25 %] vs 7%[95 %CI 3 %–13 %], p = 0.004). Conclusions: SRS2 is an effective strategy for in-site recurrence of BM previously treated with SRS.

Stereotactic reirradiation for local failure of brain metastases following previous radiosurgery: Systematic review and meta-analysis / Loi M.; Caini S.; Scoccianti S.; Bonomo P.; De Vries K.; Francolini G.; Simontacchi G.; Greto D.; Desideri I.; Meattini I.; Nuyttens J.; Livi L.. - In: CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY. - ISSN 1040-8428. - ELETTRONICO. - 153:(2020), pp. 0-0. [10.1016/j.critrevonc.2020.103043]

Stereotactic reirradiation for local failure of brain metastases following previous radiosurgery: Systematic review and meta-analysis

Loi M.;Caini S.;Scoccianti S.;Bonomo P.;Francolini G.;Simontacchi G.;Greto D.;Desideri I.;Meattini I.;Livi L.
2020

Abstract

Introduction: Local failure (LF) following stereotactic radiosurgery (SRS) of brain metastases (BM) may be treated with a second course of SRS (SRS2), though this procedure may increase the risk of symptomatic radionecrosis (RN). Methods: A literature search was conducted according to PRISMA to identify studies reporting LF, overall survival (OS) and RN rates following SRS2. Meta-analysis was performed to identify predictors of RN. Results: Analysis included 11 studies (335 patients,389 metastases). Pooled 1-year LF was 24 %(CI95 % 19–30 %): heterogeneity was acceptable (I2 = 21.4 %). Median pooled OS was 14 months (Confidence Interval 95 %, CI95 % 8.8–22.0 months). Cumulative crude RN rate was 13 % (95 %CI 8 %–19 %), with acceptable heterogeneity (I2 = 40.3 %). Subgroup analysis showed higher RN incidence in studies with median patient age ≥59 years (13 % [95 %CI 8 %–19 %] vs 7 %[95 %CI 3 %–12 %], p = 0.004) and lower incidence following prior Whole Brain Radiotherapy (WBRT, 19 %[95 %CI 13 %–25 %] vs 7%[95 %CI 3 %–13 %], p = 0.004). Conclusions: SRS2 is an effective strategy for in-site recurrence of BM previously treated with SRS.
2020
153
0
0
Goal 3: Good health and well-being for people
Loi M.; Caini S.; Scoccianti S.; Bonomo P.; De Vries K.; Francolini G.; Simontacchi G.; Greto D.; Desideri I.; Meattini I.; Nuyttens J.; Livi L.
File in questo prodotto:
File Dimensione Formato  
2020_Loi_CROH_SBRT reirradiaion for brain met review.pdf

accesso aperto

Tipologia: Pdf editoriale (Version of record)
Licenza: Open Access
Dimensione 587.43 kB
Formato Adobe PDF
587.43 kB Adobe PDF

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1211545
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 15
  • ???jsp.display-item.citation.isi??? 12
social impact