Yuan Xi, Liu Wen-Jie, Li Bing, Shen Ze-Tian, Shen Jun-Shu, Zhu Xi-Xu
Department of Radiation Oncology, Nanjing General Hospital of Nanjing Military Command, Medical School of Nanjing University Blood Purification Center, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China.
Medicine (Baltimore). 2017 Aug;96(34):e7698. doi: 10.1097/MD.0000000000007698.
This study was conducted to compare the effects of whole brain radiotherapy (WBRT) and stereotactic radiotherapy (SRS) in treatment of brain metastasis.A systematical retrieval in PubMed and Embase databases was performed for relative literatures on the effects of WBRT and SRS in treatment of brain metastasis. A Bayesian network meta-analysis was performed by using the ADDIS software. The effect sizes included odds ratio (OR) and 95% confidence interval (CI). A random effects model was used for the pooled analysis for all the outcome measures, including 1-year distant control rate, 1-year local control rate, 1-year survival rate, and complication. The consistency was tested by using node-splitting analysis and inconsistency standard deviation. The convergence was estimated according to the Brooks-Gelman-Rubin method.A total of 12 literatures were included in this meta-analysis. WBRT + SRS showed higher 1-year distant control rate than SRS. WBRT + SRS was better for the 1-year local control rate than WBRT. SRS and WBRT + SRS had higher 1-year survival rate than the WBRT. In addition, there was no difference in complication among the three therapies.Comprehensively, WBRT + SRS might be the choice of treatment for brain metastasis.
本研究旨在比较全脑放疗(WBRT)与立体定向放疗(SRS)治疗脑转移瘤的效果。对PubMed和Embase数据库进行系统检索,以获取关于WBRT和SRS治疗脑转移瘤效果的相关文献。使用ADDIS软件进行贝叶斯网络荟萃分析。效应量包括比值比(OR)和95%置信区间(CI)。对所有结局指标,包括1年远处控制率、1年局部控制率、1年生存率和并发症,采用随机效应模型进行合并分析。通过节点拆分分析和不一致标准差检验一致性。根据布鲁克斯-格尔曼-鲁宾方法估计收敛性。本荟萃分析共纳入12篇文献。WBRT+SRS的1年远处控制率高于SRS。WBRT+SRS在1年局部控制率方面优于WBRT。SRS和WBRT+SRS的1年生存率高于WBRT。此外,三种治疗方法在并发症方面无差异。综合来看,WBRT+SRS可能是脑转移瘤的治疗选择。