title: Whole brain radiotherapy combined with stereotactic radiotherapy versus stereotactic radiotherapy alone for brain metastases: a meta-analysis.
abstract: OBJECTIVE
  This study was to evaluate the effect of whole brain radiation (WBRT) combined with stereotactic radiotherapy (SRS) versus stereotactic radiotherapy alone for patients with brain metastases using a meta- analysis.
  
  
  METHODS
  We searched PubMed, EMBASE, Cochrane Library from their inception up to October 2013. Randomized controlled trials involving whole brain radiation combined with stereotactic radiotherapy versus stereotactic radiotherapy alone for brain metastases were included. Statistical analyses were performed using RevMan5.2 software.
  
  
  RESULTS
  Four randomized controlled trials including 903 patients were included. The meta-analysis showed statistically significant lowering of the local recurrence rate (OR=0.29, 95%CI: 0.17~0.49), new brain metastasis rate (OR=0.45, 95%CI: 0.28~0.71) and symptomatic late neurologic radiation toxicity rate (OR=3.92, 95%CI: 1.37~11.20) in the combined group. No statistically significant difference existed in the 1-year survival rate (OR=0.78, 95%CI: 0.60~1.03).
  
  
  CONCLUSIONS
  The results indicate that whole brain radiotherapy combined with stereotactic radiotherapy has advantages in local recurrence and new brain metastasis rates, but stereotactic radiotherapy alone is associated with better neurological function. However, as the samples included were not large, more high-quality, large-sample size studies are necessary for confirmation.
authors.affiliation: Evidence-Based Medicine Center, Lanzhou University, Lanzhou, China E-mail : kehuyangebm2006@126.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Duan
authors.forename: Rong
authors.initials: R
authors.lastname: Zeng
authors.forename: Ke-Hu
authors.initials: KH
authors.lastname: Yang
authors.forename: Jin-Hui
authors.initials: JH
authors.lastname: Tian
authors.forename: Xiao-Lu
authors.initials: XL
authors.lastname: Wu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Dai
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Niu
authors.forename: Di-Wa
authors.initials: DW
authors.lastname: Ma
mesh_terms: D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000379:methods*; D006801:Humans; D011379:Prognosis; D016634:Radiosurgery / Q000379:methods*; D016032:Randomized Controlled Trials as Topic