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Frameless stereotactic radiosurgery for brain metastasis: a systematic review and meta-analysis. | LitMetric

AI Article Synopsis

  • Stereotactic Radiosurgery (SRS) is a technique that focuses high doses of radiation on specific brain areas while protecting surrounding healthy tissue; this study compares the traditional frame-based method to a newer frameless approach for treating brain metastases.
  • The research followed systematic review protocols and analyzed 499 studies, narrowing it down to 35 for detailed data assessment, yielding promising overall survival and local control rates for patients undergoing frameless SRS.
  • The meta-analysis demonstrated that frameless SRS effectively improves survival and local control for brain metastasis patients, with significant rates such as a 75% 6-month overall survival rate and a 93% local control rate after 6 months.*

Article Abstract

Stereotactic Radiosurgery (SRS) delivers a high dose of radiation to a specific brain area while limiting radiation to nearby healthy tissue. While most SRS has traditionally been performed with a stereotactic frame-based approach, this study aims to investigate the safety and efficacy of frameless radiosurgery in patients with brain metastases. Our study followed the recommended guidelines summarized in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The electronic databases of PubMed/Medline, Scopus, Embase, and Web of Science (WOS) were searched from inception to 10 October 2023. The pooled rate of outcomes was calculated using random effect model and Restricted maximum-likelihood (REML) method. All statistical analysis was performed by STATA V.17. A total of 499 studies were recruited from the electronic databases. After removing duplicates (n = 117), 382 studies were used for title/abstract, and 329 were removed from the study selection process. A total of 53 articles were used for full-text assessment, and 35 studies were included for data extraction. Our analysis revealed a significant increase across all pooled survival rates and local control rates by initiating the radiosurgery for patients, estimating the pooled 6-month OSR of 75% (95% CI: 68-81%), 1-year overall survival rate (OSR) of 60% (95% CI: 51-69%), 18-month OSR of 48% (95% CI: 10-85%), 2-year OSR of 39% (95% CI: 19-58%), 1-year progression-free survival rate (PFSR) of 68% (95% CI: 39-98%), 2-year PFSR of 75% (95% CI: 58-91%), 6-month local control rate (LCR) of 93% (95% CI: 90-96%), and 12-month LCR of 86% (95% CI: 82-90%). Our meta-analysis findings confirm the efficacy of frameless radiosurgery in treating brain metastases. Using data from several trials, we were able to demonstrate stereotactic radiosurgery's effectiveness as a therapy option for brain metastasis patients, demonstrating local control and reasonable overall survival.

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Source
http://dx.doi.org/10.1007/s10143-024-02666-9DOI Listing

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