Browse > Article
http://dx.doi.org/10.7314/APJCP.2013.14.12.7401

Survival Outcomes after Whole Brain Radiation Therapy and/or Stereotactic Radiosurgery for Cancer Patients with Metastatic Brain Tumors in Korea: A Systematic Review  

Hyun, Min Kyung (National Evidence-based Healthcare Collaborating Agency)
Hwang, Jin Seub (National Evidence-based Healthcare Collaborating Agency)
Kim, Jin Hee (National Evidence-based Healthcare Collaborating Agency)
Choi, Ji Eun (National Evidence-based Healthcare Collaborating Agency)
Jung, Sung Young (National Evidence-based Healthcare Collaborating Agency)
Bae, Jong-Myon (National Evidence-based Healthcare Collaborating Agency)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.14, no.12, 2013 , pp. 7401-7407 More about this Journal
Abstract
Aim: To compare survival outcomes after whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS), and WBRT plus SRS combination therapy in Korea, by performing a quantitative systematic review. Materials and Methods: We searched 10 electronic databases for reports on Korean patients treated with WBRT or SRS for brain metastases published prior to July 2010. Independent reviewers screened all articles and extracted the data. When a Kaplan-Meier survival curve was available, median survival time and standard errors were calculated. Summary estimates for the outcomes in each study were calculated using the inverse variance random-effects method. Results: Among a total of 2,761 studies, 20 studies with Korean patients (n=1,053) were identified. A combination of 12 studies (n=566) with WBRT outcomes showed a median survival time of 6.0 months (95%CI: 5.9-6.2), an overall survival rate of 5.6% (95%CI: 1-24), and a 6-month survival rate of 46.5% (95%CI: 37.2-56.1). For nine studies (n=412) on SRS, the median survival was 7.9 months (95%CI: 5.1-10.8), and the 6-month survival rate was 63.1% (95%CI: 49.8-74.8). In six studies (n=75) using WBRT plus SRS, the median survival was 10.7 months (95%CI: 4.7-16.6), and the overall and 6-month survival rates were 16.8% (95%CI: 6.2-38.2) and 85.7% (95%CI: 28.3-96.9), respectively. Conclusions: WBRT plus SRS showed better 1-year survival outcome than of WBRT alone for Korean patients with metastatic brain tumors. However, the results of this analysis have to be interpreted cautiously, because the risk factors of patients were not adjusted in the included studies.
Keywords
Neoplasm metastasis; brain; radiotherapy; radiosurgery; Korean patients;
Citations & Related Records
Times Cited By KSCI : 6  (Citation Analysis)
연도 인용수 순위
1 Kim CS, Kang SS, Jung S, et al (2002). Prognostic factors in patients with brain metastases. J Korean Neurosurg Soc, 31, 203-9.   과학기술학회마을
2 Cairncross JG, Kim JH, Posner JB, et al (1980). Radiation therapy for brain metastases. Ann Neurol, 7, 529-41.   DOI   ScienceOn
3 Carey TS, Boden SD (2003). A critical guide to case series reports. Spine, 28, 1631-4.
4 Chang EL, Wefel JS, Hess KR, et al (2009). Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol, 10, 1037-44.   DOI   ScienceOn
5 Chidel MA, Suh JH, Reddy C.A, et al. (2000). Application of recursive partitioning analysis and evaluation of the use of whole brain radiation among patients treated with stereotactic radiosurgery for newly diagnosed brain metastases. Int J Radiat Oncol Biol Phys, 47, 993-9   DOI   ScienceOn
6 Cho MJ, Kim KH, Jang JY (2000). Initial experience of fractionated dtereotactic radiotherapy for metastatic brain tumors. J Korean Cancer Assoc, 32, 374-81.
7 Combs SE, D. Schulz-Ertner D, Thilmann, C, et al (2004). Treatment of cerebral metastases from breast cancer with stereotactic radiosurgery. Strahlenther Onkol, 180, 590-6.   DOI
8 Datta R, Jawahar A, Ampil FL, et al (2004). Survival in relation to radiotherapeutic modality for brain metastasis: whole brain irradiation vs. gamma knife radiosurgery. Am J Clin Oncol, 27, 420-4.   DOI   ScienceOn
9 Fox BD, Cheung VJ, Patel AJ, et al (2011). Epidemiology of metastatic brain tumors. Neurosurg Clin N Am, 22, 1-6.   DOI   ScienceOn
10 Gu HW, Sohn MJ, Lee DJ, et al (2009). Clinical analysis of novalis stereotactic radiosurgery for brain metastases. J Korean Neurosurg Soc, 46, 245-51.   과학기술학회마을   DOI   ScienceOn
11 Gwak HK, Kim WC, Kim HJ, et al (2009). Survival analysis of patients with brain metastasis by weighting according to the primary tumor oncotype. J Korean Soc Ther Radiol Oncol, 27, 140-4.   DOI   ScienceOn
12 Han JH, Kim DG, Park JC, et al (2010). Little response of cerebral metastasis from hepatocellular carcinoma to any treatments. J Korean Neurosurg Soc, 47, 325-31.   과학기술학회마을   DOI   ScienceOn
13 Hoffman R, Sneed PK, McDermott MW, et al (2001). Radiosurgery for brain metastases from primary lung carcinoma. Cancer J, 7, 121-31.
14 Hong SE (1994). Accelerated fractionation in the treatment of brain metastasis from non-small cell carcinoma of the lung. J Korean Soc Ther Radiol, 12, 165-73.   과학기술학회마을
15 Andrews DW, Scott CB, Sperduto PW, et al (2004). Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet, 363, 1665-72.   DOI   ScienceOn
16 Aoyama H, Shirato H, Tago M, et al (2006). Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA, 295, 2483-91.   DOI   ScienceOn
17 Jang SS, Park WY, Kim WD. Palliative Radiotherapy for Brain metastases. J Korean Soc Ther Radiol Oncol, 16, 177-84.   과학기술학회마을
18 Kim CJ, Baek MY, Park SK, et al (2009). Comparison of stereotactic radiosurgery and whole brain radiotherapy in patients with four or more brain metastases. J Korean Soc Ther Radiol, 27, 163-8.   과학기술학회마을   DOI   ScienceOn
19 Kim DY, Ahn YC, Huh SJ, et al (2000). Stereotactic radiotherapy for the treatment of brain metastases. J Korean Cancer Assoc, 32, 148-55.
20 Kim HJ, Hong SM, Kim SZ, et al (2003). Efficacy of whole brain radiotherapy combined with fractionated stereotactic radiotherapy in metastatic brain tumors, and prognostic factors. Radiat Med, 21, 155-60.
21 Kim IK, Lee RA, Moon SM, et al (2003). Brain metastasis of colorectal cancer. J Korean Soc Coloproctol, 19, 165-9.   과학기술학회마을
22 Ko YS, Oh YK, Nam TK (2003). Results of palliative radiotherapy to the metastatic brain tumor. Med J Chosun Univ, 28, 50-8.
23 Kondziolka D, Patel A, Lunsford LD, et al (1999). Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys, 45, 427-34.
24 Kwon KY, Kong DS, Lee JI, et al (2007). Outcome of repeated radiosurgery for recurrent metastatic brain tumors. Clin Neurol Neurosurg, 109, 132-7.   DOI   ScienceOn
25 Lee JD, Yoon JH, Chang HS, et al (2004). Brain metastases from well-differentiated thyroid carcinoma. Korean J Head Neck Oncol, 20, 7-12.   과학기술학회마을
26 Lee SN, Choo MS, Lee KJ, et al (1999). The role of radiotherapy in patients with brain metastasis. Radiation Oncol J, 17, 281-6.   과학기술학회마을
27 Lee YK, Park NH, Kim JW, et al (2008). Gamma-knife radiosurgery as an optimal treatment modality for brain metastases from epithelial ovarian cancer. Gynecol Oncol, 108, 505-59.   DOI   ScienceOn
28 NECA (2011). Utilization Patterns and Comparative Effectiveness of Radiotherapy for Metastatic Brain Tumor (NA2010-011) Seoul, Korea: The National Evidence-based Healthcare Collaborating Agency (NECA).
29 Lichtor T (2013). Clinical management and evolving novel therapeutic strategies for patients with brain tumors. In Tech Chapter, 9, 193.
30 Linskey ME, Andrews DW, Asher AL, et al (2010). The role of stereotactic radiosurgery in the management of patients with newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol, 96, 45-68.   DOI
31 33. Noel G, Medioni J, Valery CA, et al (2003). Three irradiation treatment options including radiosurgery for brain metastases from primary lung cancer. Lung Cancer, 41, 333-43.   DOI   ScienceOn
32 Park BJ, Kim YJ, Cho MK (2003). LINAC radiosurgery for metastatic brain tumors. J Korean Neurosurg Soc, 33, 276-80.   과학기술학회마을
33 SPSS (2007). PASW Statistics 17.0 Algorithms. SPSS, Inc.
34 Park SH, Hwang SK, Kang DH, et al (2009). Gamma knife radiosurgery for multiple brain metastases from lung cancer. J Clin Neurosci, 16, 626-9.   DOI   ScienceOn
35 Patil CG, Pricola K, Garg SK, et al (2010). Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases. Cochrane Database Syst Rev, 6, 6121.
36 Rades D, Pluemer A, Veninga T, et al (2007). Whole-brain radiotherapy versus stereotactic radiosurgery for patients in recursive partitioning analysis classes 1 and 2 with 1 to 3 brain metastases. Cancer, 110, 2285-92.   DOI   ScienceOn
37 Sneed PK, Lamborn KR, Forstner JM, et al (1999). Radiosurgery for brain metastases: is whole brain radiotherapy necessary?. Int J Radiat Oncol Biol Phys, 43, 549-58.   DOI   ScienceOn
38 39. Sneed PK, Suh JH, Goetsch SJ, et al (2002). A multiinstitutional review of radiosurgery alone vs. radiosurgery with whole brain radiotherapy as the initial management of brain metastases. Int J Radiat Oncol Biol Phys, 53, 519-26.   DOI   ScienceOn
39 Tierney JF, Stewart LA, Ghersi D, et al (2007). Practical methods for incorporating summary time-to-event data into metaanalysis. Trials, 8, 16.   DOI   ScienceOn
40 Yang SY, Kim DG, Lee SH, et al (2008). Pulmonary resection tin patients with nonsmall-cell lung cancer treated with gamma-knife radiosurgery for synchronous brain metastases. Cancer, 112, 1780-6.   DOI   ScienceOn
41 Yoo H, Rhee CH, Yoon SM, et al (1999). Clinical analysis of 178 metastatic brain tumors. J Korean Neurosurg Soc, 28, 1185-93.
42 Baik JS, Choi IS, Roh JK, et al (1997). Metastatic brain tumors: clinical aspects and prognosis. J Korean Neurol Assoc, 15, 358-67.