Stereotactic Radiosurgery for Metastases to the Brain: A Systematic Review ofPublished Studies of Effectiveness. Technology Assessment Program

摘要

Brain metastases, a major cause of disability and death in cancer patients, havelimited treatment options, particularly for patients with surgically inaccessible or recurrent brain metastases, Stereoactic radiosurgery (SRS), a specialized form of radiation therapy, delivers precisely focused radiation to brain lesions without harming healthy tissue. This sysematic review found that SRS works as an outpatient procedure thus using fewer resources than open cranial surgery. Relative to surgery, radiosurgery reduces hospital stays from 10 days to 3 or 4 days. The best published evidence is from case series, a relatively weak study design, that does not provide strong evidence of effectiveness. The studies reviewed treated different types of patients and reported outcomes in non-comparative ways. Effectiveness data was difficult to interpret as studies frequently combined outcomes from different patient or treatment groups. Findings about SRS effectiveness were encouraging and consistent for comparble groups of patients, but they are considered preliminary.