Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases.

Abstract:

BACKGROUND:Historically, whole brain radiation therapy (WBRT) has been the main treatment for brain metastases. Stereotactic radiosurgery (SRS) delivers high-dose focused radiation and is being increasingly utilized to treat brain metastases. The benefit of adding SRS to WBRT is unclear. This is an updated version of the original Cochrane review published in Issue 6, 2010. OBJECTIVES:To assess the efficacy of WBRT plus SRS versus WBRT alone in the treatment of brain metastases. SEARCH METHODS:In the original review we searched the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2009), MEDLINE (1966 to 2009), EMBASE (1980 to 2009), and CancerLit (1975 to 2009) in order to identify trials for inclusion in this review.In this update we searched the following electronic databases in May 2012: Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 5, 2012), MEDLINE (2009 to May week 4 2012), and EMBASE (2009 to 2012 week 21) in order to identify trials for inclusion in the review. SELECTION CRITERIA:The review was restricted to randomized controlled trials (RCTs) that compared use of WBRT plus SRS versus WBRT alone for upfront treatment of adult patients with newly diagnosed metastases (single or multiple) in the brain resulting from any primary, extracranial cancer. DATA COLLECTION AND ANALYSIS:The Generic Inverse Variance method, random-effects model in RevMan 5 was used for the meta-analysis. MAIN RESULTS:A meta-analysis of two trials with a total of 358 participants, found no statistically significant difference in overall survival (OS) between WBRT plus SRS and WBRT alone groups (hazard ratio (HR) 0.82; 95% confidence interval (CI) 0.65 to 1.02). For patients with one brain metastasis median survival was significantly longer in WBRT plus SRS group (6.5 months) versus WBRT group (4.9 months; P = 0.04). Patients in the WBRT plus SRS group had decreased local failure compared to patients who received WBRT alone (HR 0.27; 95% CI 0.14 to 0.52). Furthermore, a statistically significant improvement in performance status scores and decrease in steroid use was seen in the WBRT plus SRS group. Unchanged or improved Karnofsky Performance Scale (KPS) at 6 months was seen in 43% of patients in the combined therapy group versus only 28% in WBRT group (P = 0.03). Overall, risk of bias in the included studies was unclear. AUTHORS' CONCLUSIONS:Since the last version of this review no new studies were found that met the inclusion criteria. Given the unclear risk of bias in the included studies, the results of this analysis have to be interpreted with caution. Analysis of all included patients, SRS plus WBRT, did not show a survival benefit over WBRT alone. However, performance status and local control were significantly better in the SRS plus WBRT group. Furthermore, significantly longer OS was reported in the combined treatment group for recursive partitioning analysis (RPA) Class I patients as well as patients with single metastasis.

authors

Patil CG,Pricola K,Sarmiento JM,Garg SK,Bryant A,Black KL

doi

10.1002/14651858.CD006121.pub3

subject

Has Abstract

pub_date

2012-09-12 00:00:00

pages

CD006121

issue

9

issn

1469-493X

pub_type

杂志文章,meta分析,评审
  • Re-feeding versus discarding gastric residuals to improve growth in preterm infants.

    abstract:BACKGROUND:Routine monitoring of gastric residuals in preterm infants on gavage feeds is a common practice in many neonatal intensive care units and is used to guide the initiation and advancement of feeds. No guidelines or consensus is available on whether to re-feed or discard the aspirated gastric residuals. Althoug...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD012940.pub2

    authors: Abiramalatha T,Thanigainathan S,Balakrishnan U

    更新日期:2019-07-08 00:00:00

  • Angiogenesis-inhibitors for metastatic thyroid cancer.

    abstract:BACKGROUND:Systemic cytostatic therapies for advanced, metastatic thyroid carcinomas have been poorly effective. Tumor growth and metastasis depend on blood supply and blood vessel formation (angiogenesis). Therefore, inhibition of angiogenesis may represent a promising target for cancer therapy. OBJECTIVES:To evaluat...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007958.pub2

    authors: Tan A,Xia N,Gao F,Mo Z,Cao Y

    更新日期:2010-03-17 00:00:00

  • Ivermectin versus albendazole or thiabendazole for Strongyloides stercoralis infection.

    abstract:BACKGROUND:Strongyloidiasis is a gut infection with Strongyloides stercoralis which is common world wide. Chronic infection usually causes a skin rash, vomiting, diarrhoea or constipation, and respiratory problems, and it can be fatal in people with immune deficiency. It may be treated with ivermectin or albendazole or...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007745.pub3

    authors: Henriquez-Camacho C,Gotuzzo E,Echevarria J,White AC Jr,Terashima A,Samalvides F,Pérez-Molina JA,Plana MN

    更新日期:2016-01-18 00:00:00

  • Laparoscopy versus laparotomy for FIGO stage I ovarian cancer.

    abstract:BACKGROUND:This is an updated version of the original review that was first published in the Cochrane Database of Systematic Reviews 2008, Issue 4. Laparoscopy has become an increasingly common approach to surgical staging of apparent early-stage ovarian tumours. This review was undertaken to assess the available evide...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005344.pub3

    authors: Lawrie TA,Medeiros LR,Rosa DD,da Rosa MI,Edelweiss MI,Stein AT,Zelmanowicz A,Ethur AB,Zanini RR

    更新日期:2013-02-28 00:00:00

  • Systemic antifungal therapy for tinea capitis in children.

    abstract:BACKGROUND:Tinea capitis is a common contagious fungal infection of the scalp in children. Systemic therapy is required for treatment and to prevent spread. This is an update of the original Cochrane review. OBJECTIVES:To assess the effects of systemic antifungal drugs for tinea capitis in children. SEARCH METHODS:We...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004685.pub3

    authors: Chen X,Jiang X,Yang M,González U,Lin X,Hua X,Xue S,Zhang M,Bennett C

    更新日期:2016-05-12 00:00:00

  • Surgery for post-vitrectomy cataract.

    abstract:BACKGROUND:Cataract formation or acceleration can occur after intraocular surgery, especially following vitrectomy, a surgical technique for removing the vitreous used in the treatment of disorders that affect the posterior segment of the eye. OBJECTIVES:The objective of this review was to evaluate benefits and advers...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006366.pub2

    authors: Do DV,Hawkins B,Gichuhi S,Vedula SS

    更新日期:2008-07-16 00:00:00

  • Trastuzumab-containing regimens for metastatic breast cancer.

    abstract:BACKGROUND:Patients with breast cancer are classified as having cells that over-express the human epidermal growth factor receptor 2 (known as HER2-positive) or not (HER2-negative). Typically, patients with HER2-positive disease have a worse prognosis. Trastuzumab is a selective treatment that targets the HER2 pathway....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006242.pub2

    authors: Balduzzi S,Mantarro S,Guarneri V,Tagliabue L,Pistotti V,Moja L,D'Amico R

    更新日期:2014-06-12 00:00:00

  • Vitamin A and fish oils for retinitis pigmentosa.

    abstract:BACKGROUND:Retinitis pigmentosa (RP) comprises a group of hereditary eye diseases characterized by progressive degeneration of retinal photoreceptors. It results in severe visual loss that may lead to legal blindness. Symptoms may become manifest during childhood or adulthood, and include poor night vision (nyctalopia)...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008428.pub2

    authors: Rayapudi S,Schwartz SG,Wang X,Chavis P

    更新日期:2013-12-19 00:00:00

  • Moderately early (7-14 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants.

    abstract:BACKGROUND:Corticosteroids have been used late in the neonatal period to treat chronic lung disease (CLD) in preterm babies, and early to try to prevent it. CLD is likely to be the result of persisting inflammation in the lung and the use of powerful anti-inflammatory drugs like dexamethasone has some rationale. Early ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001144

    authors: Halliday HL,Ehrenkranz RA,Doyle LW

    更新日期:2003-01-01 00:00:00

  • Botulinum toxin type A versus botulinum toxin type B for cervical dystonia.

    abstract:BACKGROUND:Cervical dystonia is the most common form of focal dystonia. It is characterized by involuntary posturing of the head and frequently is associated with neck pain. Disability and social withdrawal are common. Most cases are idiopathic, and generally it is a life-long disorder. In recent years, botulinum toxin...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004314.pub2

    authors: Costa J,Borges A,Espírito-Santo C,Ferreira J,Coelho M,Moore P,Sampaio C

    更新日期:2005-01-25 00:00:00

  • Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.

    abstract:BACKGROUND:Multiple pregnancy is a strong risk factor for preterm birth, and more than 50% of women with a twin pregnancy will give birth prior to 37 weeks' gestation. Infants born preterm are recognised to be at increased risk of many adverse health outcomes, contributing to more than half of overall perinatal mortali...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD012024.pub2

    authors: Dodd JM,Grivell RM,OBrien CM,Dowswell T,Deussen AR

    更新日期:2017-10-31 00:00:00

  • Early use of inhaled corticosteroids in the emergency department treatment of acute asthma.

    abstract:BACKGROUND:Systemic corticosteroid therapy is central to the management of acute asthma The use of inhaled corticosteroids may also be beneficial in this setting. OBJECTIVES:To determine the benefit of inhaled corticosteroids for the treatment of patients with acute asthma managed in the emergency department (ED). SE...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002308

    authors: Edmonds ML,Camargo CA Jr,Pollack CV Jr,Rowe BH

    更新日期:2003-01-01 00:00:00

  • Adjuvant radiotherapy and chemoradiation after surgery for cervical cancer.

    abstract:BACKGROUND:There is an ongoing debate about the indications for, and value of, adjuvant pelvic radiotherapy after radical surgery in women with early cervical cancer. Certain combinations of pathologic risk factors are thought to represent sufficient risk for recurrence, that they justify the use of post-operative pelv...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007583.pub2

    authors: Rogers L,Siu SS,Luesley D,Bryant A,Dickinson HO

    更新日期:2009-10-07 00:00:00

  • Ibuprofen with or without an antiemetic for acute migraine headaches in adults.

    abstract:BACKGROUND:Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers do not seek professional help, relying instead on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce symptoms commonly associated with migraine headaches. OBJE...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008039.pub2

    authors: Rabbie R,Derry S,Moore RA,McQuay HJ

    更新日期:2010-10-06 00:00:00

  • Botulinum toxin injections for the treatment of spasmodic dysphonia.

    abstract:BACKGROUND:The use of botulinum toxin for the treatment of spasmodic dysphonia is currently the treatment of choice for management of this neurological voice disorder. Over the past 20 years, botulinum toxin has been used to treat both adductor and abductor forms of the disorder, with vocal improvement noted after trea...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004327.pub2

    authors: Watts CC,Whurr R,Nye C

    更新日期:2004-01-01 00:00:00

  • Unconditional cash transfers for reducing poverty and vulnerabilities: effect on use of health services and health outcomes in low- and middle-income countries.

    abstract:BACKGROUND:Unconditional cash transfers (UCTs; provided without obligation) for reducing poverty and vulnerabilities (e.g. orphanhood, old age or HIV infection) are a type of social protection intervention that addresses a key social determinant of health (income) in low- and middle-income countries (LMICs). The relati...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011135.pub2

    authors: Pega F,Liu SY,Walter S,Pabayo R,Saith R,Lhachimi SK

    更新日期:2017-11-15 00:00:00

  • Vitamin E supplementation in people with cystic fibrosis.

    abstract:BACKGROUND:People with cystic fibrosis are at an increased risk of fat-soluble vitamin deficiency, including vitamin E. Vitamin E deficiency can cause a host of conditions such as haemolytic anaemia, cerebellar ataxia and cognitive difficulties. Vitamin E supplementation is widely recommended for people with cystic fib...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD009422.pub4

    authors: Okebukola PO,Kansra S,Barrett J

    更新日期:2020-09-06 00:00:00

  • Non-vitamin K antagonist oral anticoagulants (NOACs) post-percutaneous coronary intervention: a network meta-analysis.

    abstract:BACKGROUND:Clinicians must balance the risks of bleeding and thrombosis after percutaneous coronary intervention (PCI) in people with an indication for anticoagulation. The potential of non-vitamin K antagonists (NOACs) to prevent bleeding complications is promising, but evidence remains limited. OBJECTIVES:To review ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD013252.pub2

    authors: Al Said S,Alabed S,Kaier K,Tan AR,Bode C,Meerpohl JJ,Duerschmied D

    更新日期:2019-12-19 00:00:00

  • Prophylactic natural surfactant extract for preventing morbidity and mortality in preterm infants.

    abstract:BACKGROUND:This section is under preparation and will be included in the next issue. OBJECTIVES:To assess the effect of prophylactic intratracheal administration of natural surfactant extract in preterm newborns at risk for developing respiratory distress syndrome (RDS). SEARCH STRATEGY:Searches were made of the Oxfo...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000511

    authors: Soll RF

    更新日期:2000-01-01 00:00:00

  • Treatment of hypertension in peripheral arterial disease.

    abstract:BACKGROUND:Peripheral arterial disease (PAD) causes considerable morbidity and mortality. Hypertension is a risk factor for PAD. Treatment for hypertension must be compatible with the symptoms of PAD. Controversy regarding the effects of beta-blockade for hypertension in patients with PAD has led many physicians to sto...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003075.pub2

    authors: Lane DA,Lip GY

    更新日期:2009-10-07 00:00:00

  • Arginine supplementation for prevention of necrotising enterocolitis in preterm infants.

    abstract:BACKGROUND:Decreased concentration of nitric oxide has been proposed as one of the possible cellular mechanisms of necrotising enterocolitis (NEC). Arginine can act as a substrate for production of nitric oxide in the tissues, and arginine supplementation may help to prevent NEC. OBJECTIVES:To examine the effect of ar...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004339.pub4

    authors: Shah PS,Shah VS,Kelly LE

    更新日期:2017-04-11 00:00:00

  • Compulsory community and involuntary outpatient treatment for people with severe mental disorders.

    abstract:BACKGROUND:There is controversy as to whether compulsory community treatment for people with severe mental illnesses reduces health service use, or improves clinical outcome and social functioning. Given the widespread use of such powers it is important to assess the effects of this type of legislation. OBJECTIVES:To ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004408.pub2

    authors: Kisely S,Campbell LA,Preston N

    更新日期:2005-07-20 00:00:00

  • Growth hormone therapy for people with thalassaemia.

    abstract:BACKGROUND:Thalassaemia is a recessively-inherited blood disorder that leads to anaemia of varying severity. In those affected by the more severe forms, regular blood transfusions are required which may lead to iron overload. Accumulated iron from blood transfusions may be deposited in vital organs including the heart,...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD012284.pub2

    authors: Ngim CF,Lai NM,Hong JY,Tan SL,Ramadas A,Muthukumarasamy P,Thong MK

    更新日期:2017-09-18 00:00:00

  • Venepuncture versus heel lance for blood sampling in term neonates.

    abstract:BACKGROUND:Heel lance has been the conventional method of blood sampling in neonates for screening tests. Neonates undergoing this procedure experience pain. Despite various studies evaluating the role of pharmacological and non-pharmacological interventions to date, there are no effective and practical methods to alle...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001452

    authors: Shah V,Ohlsson A

    更新日期:2001-01-01 00:00:00

  • Exercise for women receiving adjuvant therapy for breast cancer.

    abstract:BACKGROUND:A huge clinical research database on adjuvant cancer treatment has verified improvements in breast cancer outcomes such as recurrence and mortality rates. On the other hand, adjuvant therapy with agents such as hormone therapy, chemotherapy and radiotherapy impacts on quality of life due to substantial short...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005001.pub2

    authors: Markes M,Brockow T,Resch KL

    更新日期:2006-10-18 00:00:00

  • Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND).

    abstract:BACKGROUND:Riluzole has been approved for treatment of patients with amyotrophic lateral sclerosis in most countries. Questions persist about its clinical utility because of high cost and modest efficacy. OBJECTIVES:To examine the efficacy of riluzole in prolonging survival, and in delaying the use of surrogates (trac...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001447.pub2

    authors: Miller RG,Mitchell JD,Lyon M,Moore DH

    更新日期:2007-01-24 00:00:00

  • Routine anticonvulsants for treating cerebral malaria.

    abstract:BACKGROUND:Cerebral malaria is a common complication of Plasmodium falciparum infection, and kills over a million people every year. People with cerebral malaria become unconscious, and often have protracted convulsions. It is unclear whether giving anticonvulsant drugs routinely to people with cerebral malaria will im...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002152

    authors: Meremikwu M,Marson AG

    更新日期:2002-01-01 00:00:00

  • Hyperfractionated or accelerated radiotherapy for head and neck cancer.

    abstract:BACKGROUND:Several trials have studied the role of altered fractionation radiotherapy in head and neck squamous cell carcinoma, but the effect of such treatment on survival is not clear. OBJECTIVES:The aim of this individual patient data (IPD) meta-analysis was to assess whether this type of radiotherapy could improve...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002026

    authors: Baujat B,Bourhis J,Blanchard P,Overgaard J,Ang KK,Saunders M,Le Maître A,Bernier J,Horiot JC,Maillard E,Pajak TF,Poulsen MG,Bourredjem A,O'Sullivan B,Dobrowsky W,Andrzej H,Skladowski K,Hay JH,Pinto LH,Fu KK,Fallai

    更新日期:2010-12-08 00:00:00

  • Oestrogens for preventing recurrent urinary tract infection in postmenopausal women.

    abstract:BACKGROUND:Recurrent urinary tract infection (RUTI) is defined as three episodes of urinary tract infection (UTI) in the previous 12 months or two episodes in the last six months. The main factors associated with RUTI in postmenopausal women are vesical prolapse, cystocoele, post-voidal residue and urinary incontinence...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005131.pub2

    authors: Perrotta C,Aznar M,Mejia R,Albert X,Ng CW

    更新日期:2008-04-16 00:00:00

  • Balneotherapy for osteoarthritis.

    abstract:BACKGROUND:Balneotherapy (or spa therapy, mineral baths) for patients with arthritis is one of the oldest forms of therapy. One of the aims of balneotherapy is to soothe the pain and as a consequence to relieve patients' suffering and make them feel well. In this update we included one extra study. OBJECTIVES:To asses...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006864

    authors: Verhagen AP,Bierma-Zeinstra SM,Boers M,Cardoso JR,Lambeck J,de Bie RA,de Vet HC

    更新日期:2007-10-17 00:00:00