Abstract Details

Title Efficacy and Safety of Stereotactic Radiosurgery Versus Whole Brain Radiotherapy for the Management of Brain Metastasis: A Systematic Review and Meta-analysis

Topic Neuro-oncology

Presentation(s) P4 - Poster Session 4 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-011

Objective The primary objective of this review is to provide a comprehensive synthesis of the existing high-quality evidence that compares the outcomes of WBRT and SRS for the management of brain metastases.

Background Whole-brain radiotherapy (WBRT) has historically been the first choice for most patients with brain metastasis (BMs), despite its adverse effects on patients’ general health. Recently, stereotactic radiosurgery (SRS) has emerged as a safe and effective potential alternative for patients with BMs.

Design/Methods We searched electronic databases such as PubMed, Scopus, WOS, and Cochrane CENTRAL for relevant comparative studies comparing SRS and WBRT for BMs. Eligible studies were selected, and their data were extracted from a uniform data extraction sheet and analyzed using the RevMan software (version 5.2).

Results Thirty-five studies (n= 26 observational and n= 9 RCTs) were included in this meta-analysis (total n = 26000 patients). SRS was associated with longer survival time (MD 4.38 months, 95% CI [3.09, 6.56], P < 0.00001); however, this difference was mainly driven by the retrospective studies, and evidence from 2 RCTs showed comparable survival times. SRS was associated with a longer time to intracranial progression (SMD -0.94, 95% CI [-1.64, -0.23], P = 0.009) and better local intracranial control (RR 1.20, 95% CI [1.01, 1.42], P = 0.04). SRS showed no significant difference in distant intracranial control compared to WBRT (OR 0.61, 95% CI [0.32, 1.19], P = 0.15). There were significant differences between the two arms regarding adverse events associated with WBRT, such as headache, vomiting, motor dysfunction, radiation necrosis, and fatigue.

Conclusions SRS has been associated with better survival and local tumor control. It is a safer procedure that enhances short-term quality of life and preserves cognitive function in the long term. Thus, SRS alone is a suitable recommendation for patients at a high risk of neurocognitive decline.

Authors/Disclosures
Ahmed Negida, MD, PhD (Virginia Commonwealth University) PRESENTER	Dr. Negida has nothing to disclose.
Shrouk F. Mohamed	Dr. Mohamed has nothing to disclose.
Emad Singer, MD	Dr. Singer has received personal compensation for serving as an employee of MD Anderson Cancer Center.
Hebatalla M. Farouk	No disclosure on file
Abdelrahman R. Youssef	Dr. Youssef has nothing to disclose.
Mohamed Elmallahy	No disclosure on file
Hazem S. Ghaith	No disclosure on file
Amr Moursi	No disclosure on file

��ɫ��

��ɫ��