Stereotactic radiosurgery for brain metastasis from gynecological cancers: A systematic review.

BACKGROUND

Though rare in gynecologic cancers, brain metastases have become more frequently diagnosed, likely due to improved treatments and clinical awareness. Stereotactic radiosurgery (SRS) is a precise treatment option showing promise for these cases. This systematic literature review evaluates the outcomes of SRS for gynecologic cancer brain metastases to guide clinical decision-making.

METHODS

This systematic review followed PRISMA guidelines to identify clinical studies on the use of SRS for brain metastases from gynecological cancers. Searches were conducted in PubMed, Scopus, and EMBASE for English-only articles from 2000 to 2024, and studies were independently screened by three authors. Study bias was evaluated across seven domains.

RESULTS

Fourteen studies met criteria, encompassing 534 patients. The most common gynecological cancer studied was ovarian (299/534, 56.0%), followed by endometrial (136/534, 25.5%), and cervical cancer (93/534, 17.4%). The mean KPS was 79.0 (range, 20-100). The mean time from primary cancer diagnosis to brain metastasis diagnosis was 44.3 months (range, -1-428 months). Local control rates ranged from 66.7% to 100% with the mean, 1-year local control rate being 87.6%. Overall survival from brain metastasis diagnosis ranged from 5 to 18.5 months; higher KPS, older age, whole brain radiotherapy prior to SRS, fewer metastases, and controlled primary cancer were associated with improved survival.

CONCLUSION

Brain metastases in gynecologic cancers are rising due to improved survival. This review suggests SRS as a promising treatment, offering survival outcomes similar to other cancer types. Further research is needed to enhance prognostication and patient outcomes.