Open AccessRadiosurgery for brain oligometastases in lung cancer
Author(s) -
Gabriela Antúnez,
Tomás Merino
Publication year - 2021
Publication title -
medwave
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.178
H-Index - 7
ISSN - 0717-6384
DOI - 10.5867/medwave.2021.11.8184
Subject(s) - medicine , radiosurgery , lung cancer , systematic review , medline , meta analysis , randomized controlled trial , adverse effect , brain tumor , population , radiation therapy , oncology , intensive care medicine , medical physics , pathology , environmental health , political science , law
Brain metastases are a common problem in oncology patients, especially in lung cancer. The usual treatment for cerebral oligometastases is whole brain radiation therapy. Given the persistent poor prognosis of this disease, other therapeutic alternatives such as stereotactic radiosurgery have been considered. However, there is no clarity regarding the effectiveness of its addition. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified 17 systematic reviews including seven studies overall, of which four were randomized trials. All trials assessed patients with brain oligometastases, but none of them included exclusively lung cancer population. We concluded that it is not possible to clearly establish whether radiosurgery decreases neurological functionality, cognitive impairment, mortality or serious adverse effects, as the certainty of the existing evidence has been assessed as very low.