Radiotherapeutic management of metastatic brain disease: a two-decade meta-analysis of tumor control and neurocognitive outcomes with SRS alone versus SRS plus WBRT

Simple item page
AudienciaPúblico en generales_ES
CoberturaMéxicoes_ES
Fecha de ingreso2026-10-05T16:33:40Z
Fecha de publicación2026-01-01
ResumenIntroductionBrain metastases represent the most common intracranial tumors in adults. Stereotactic radiosurgery (SRS) is widely used for their management. However, the role of SRS plus adjunct whole-brain radiotherapy (WBRT), remains debated given the risk of neurocognitive deterioration (NCD). We conducted a comparative analysis of SRS alone versus SRS combined with WBRT in patients with brain metastases.MethodsWe identified studies evaluating SRS alone or in combination with WBRT for the management of brain metastases. Our outcomes of interest included NCD, Overall Survival (OS), Local Tumor Control (LTC), and radionecrosis (RN).ResultsWe analyzed 6 cohort studies and 4 randomized controlled trials including 1,757 patients. OS was comparable between groups (HR = 1.06;95\%CI = 0.86-1.30;p = 0.60). LTC in the SRS-alone group was 77.71\%, while SRS+WBRT group achieved a 87.25\% of LTC which was comparable between groups (RR = 1.17;95\%CI = 0.99-1.39;p = 0.07;I2 = 82\%). Recurrence rate was 13.9\% in SRS+WBRT and 37\% with SRS alone, favoring SRS+WBRT (RR = 0.37; CI95\%=0.21-0.65, p = 0.0005; I2 = 0\%). RN rate for was 3.7\% with SRS+WBRT and 3.5\% with SRS alone, which were comparable (RR = 0.99; CI95\%=0.33-2.93, p = 0.98; I2 = 0\%). NCD of >= 1SD from baseline was more frequent in the SRS+WBRT group (RR = 0.64;95\%CI = 0.47-0.87;p = 0.005).ConclusionSRS is an effective and safe therapy for metastatic brain disease. While its combination with WBRT may improve recurrence rates with stable LTC and limited RN rates, it is associated with higher rates of NCD without a clear OS benefit. Future trials should assess homogeneous populations and integrate quality-of-life outcomes to guide individualized treatment selection.Clinical trial numberNot applicable.es_ES
Doihttps://doi.org/10.1007/s11060-026-05640-1es_ES
URIhttps://riuat.uat.edu.mx/handle/123456789/5485
Idiomaenes_ES
EditorialSPRINGERes_ES
RelaciónJournal of Neuro-Oncologyes_ES
URL relacionadohttps://doi.org/10.1007/s11060-026-05640-1es_ES
DerechosAcceso restringido / Suscripción (Metadatos de producción científica)es_ES
Licenciahttp://purl.org/coar/access_right/c_16eces_ES
FuenteJournal of Neuro-Oncology
Palabra claveStereotactic radiosurgery (SRS)es_ES
Palabra claveWhole brain radiotherapy (WBRT)es_ES
Palabra claveBrain metastaseses_ES
Palabra claveLocal tumor control (LTC)es_ES
Palabra claveNeurocognitive deterioration (NCD)es_ES
Palabra claveOverall survival (OS)es_ES
Palabra claveRadionecrosis (RN)es_ES
Palabra claveOligometastaseses_ES
TítuloRadiotherapeutic management of metastatic brain disease: a two-decade meta-analysis of tumor control and neurocognitive outcomes with SRS alone versus SRS plus WBRTes_ES
TipoArtículoes_ES
ArbitradoHa sido Arbitradoes_ES
AutorPichardo-Rojas, Pavel S.
AutorGarcia-Torrico, Fabricio
AutorAndrade-Arbaiza, Edwin A.
AutorMagdaleno, Luisa Fernanda Calderon
AutorOrtiz, Arturo
AutorRomero, Miguel Angel Rodriguez
AutorPalomino-Ojeda, Cristian
AutorBekal, Mahesh
AutorShah, Ashish H.
AutorSheehan, Jason
AutorEsquenazi, Yoshua
AutorPichardo-Rojas, Pavel S.es_ES
AutorGarcia-Torrico, Fabricioes_ES
AutorAndrade-Arbaiza, Edwin A.es_ES
AutorMagdaleno, Luisa Fernanda Calderones_ES
AutorOrtiz, Arturoes_ES
AutorRomero, Miguel Angel Rodriguezes_ES
AutorPalomino-Ojeda, Cristianes_ES
AutorBekal, Maheshes_ES
AutorShah, Ashish H.es_ES
AutorSheehan, Jasones_ES
AutorEsquenazi, Yoshuaes_ES
InstituciónUniversidad Autónoma de Tamaulipas
InstituciónUniversidad Autónoma de Tamaulipases_ES
Número1es_ES
URL relacionadahttps://doi.org/10.1007/s11060-026-05640-1
Tipo de artículoIndexado
Tipo de artículoIndexadoes_ES
Volumen178es_ES

Files

Collections

Documentación Cientifica