Whether Applying Whole Brain Radiotherapy In Stereotactic Radiotherapy Benefits For Patients With Brain Metastases In Chinese Population: Evidence From Meta-Analysis

This study aimed to perform a meta-analysis on patients with brain metastasis in Chinese population treated with stereotactic radiotherapy (SRT) plus whole-brain radiotherapy (WBRT) boost (hereafter denoted as SRT+ WBRT) versus SRT alone. Methods: A comprehensive electronic search was conducted using an Internet retrieval system to identify eligible studies. The primary outcomes included one-year intracranial recurrent rate (ICR), one-year overall survival (OS), and radiation toxicity. Odds ratios and 95% confidence interval were calculated to compare the effects. Results: Twelve studies with 1046 patients were eligible for this meta-analysis. With regard to one-year ICR, SRT+WBRT showed a significant improvement compared with SRT alone (OR: 0.38, 95% CI: 0.24 similar to 0.59, P < 0.0001). When targeted on one-year OS, obvious differences favoring SRT+WBRT rather than SRT alone was found (OR: 0.71, 95% CI: 0.54 similar to 0.93, P = 0.01). However, no statistical difference radiation toxicity was observed in SRT+WBRT and SRT alone (OR: 0.95, 95% CI: 0.45 similar to 1.98, P = 0.89, respectively). Conclusions: For selected patients, the application of WBRT in SRT treatment performed an obviously better effect in controlling tumor recurrence and improving prognosis compared with SRT alone, and simultaneously shared the equivalent safety in radiation toxicity. For BM patients, SRT+WBTR exerted an obviously better effect in one-year ICR and one-year OS compared with WBRT alone. Thus, to improve the therapeutic effect, SRT+WBRT should be a routine treatment for patients with brain metastases in Chinese population.