Tsao MN et al
Cochrane Database of Systematic Reviews 2018, Issue 1. Art. No.: CD003869.
- A review of the effectiveness and adverse effects of whole brain radiotherapy (WBRT) given alone or in combination with other treatments to adults with multiple brain metastases (54 trials, n=11,898).
- Findings:
- Altered higher biological WBRT dose-fractionation schemes did not confer benefit for overall survival, neurological function, or symptom control compared with standard treatment. However, overall survival and neurological function were worse for lower biological WBRT dose-fractionation schemes than for standard dose schedules.
- The addition of WBRT to radiosurgery improved local and distant brain control (i.e. absence of new intracranial lesions at the site or outside of treated lesions after treatment) among selected people with brain metastases, but investigators reported worse cognitive outcomes and no differences in overall survival.
- Selected people with multiple brain metastases from non-small-cell lung cancer may show no difference in overall survival when optimal supportive care is given and WBRT is omitted.
- Use of other treatments (radiosensitisers, chemotherapy, or molecular targeted agents) in conjunction with WBRT remains experimental.
