Objective To evaluate the therapeutic efficacy of whole-brain radiotherapy (WBRT) alone or in combination with stereotactic radiotherapy (SRT) in patients with brain metastasis. Methods Literatures related to therapeutic efficacy comparison of WBRT+SRT versus WBRT alone for brain metastatic tumors were reviewed and comprehensively evaluated using owta-analysis method. The RevMan 4.2 software was used for Meta-analysis. Results Five reports including 559 patients, being identified as 4 randomized controlled trials and 1 cohort study, were selected for Meta-analysis. The Meta analysis results showed that: (1) Compared with WBRT alone, WBRT+SRT treatment can increase 1-year tumor control rate [OR=6.35, 95% confidence interval (CI): 1.92-20.97]. (2)There was no difference was found between WBRT+SRT treatment and WBRT alone treatment in 1-year integral survival rate [OR=1.46,95% CI: 0.96-2.22]. (3) There was no difference in 1-year survival rate between WBRT+SRT treatment and WBRT treatment in patients with brain multiple metastases [OR=1.09, 95%CI: 0.53-2.2.5], bat it was significantly higher in the WBRT+SRS treatment than in WBRT alone treatment in patients with single metastasis [OR=2.23,95% CI: 1.0S-4.7S]. Conclusions WBRT combined with SRT is a more rational and effective treatment strategy than WRT alone in the treatment of brain metastases. Especially in single brain metastasis, addition of SRT to WBRT improves not only local tumor control rate, but also 1-year survival rate.%目的 评价脑转移瘤全脑放射治疗(WBRT)联合与不联合立体定向放疗(SRT)的疗效对比.方法 采用Meta分析方法收集脑转移瘤WBRT联合与不联合SRT效果比较的相关文献进行综合评价,数据分析采用RevMan 4.2软件.结果 最终纳入5篇文献(4篇随机对照试验,1篇队列研究),共包括559例患者.Meta分析结果显示:在提高脑转移瘤患者肿瘤1年局控率方面,WBRT联合SRT明显优于单纯WBRT治疗(OR=6.35,95％CI 1.92～ 20.97)；在改善患者1年总体生存率方面,WBRT联合SRT与单纯WBRT治疗并无统计学差异(OR=1.46,95％CI 0.96～2.22)；将患者细分为单发脑转移瘤和多发脑转移瘤后进行分析显示,与单纯WBRT治疗比较,WBRT联合SRT在提高单发脑转移瘤患者1年生存率方面存在优势(OR=2.23,95％CI 1.05～4.75),对于多发脑转移瘤患者则无明显优势(OR=1.09,95％CI 0.53～2.25).结论 WB RT联合SRT是一种较为合理的脑转移瘤综合治疗方式,尤其对于单发脑转移瘤患者,除改善肿瘤局控率外,还可提高患者1年生存率.
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