Table 2.
Patient and Treatment Characteristics of the Studies That Were Used in the Meta-Analysis of Studies That Utilize Whole-Brain Radiotherapy
| First author, year | Treatment modality | Age (years) | Tumor diameter (cm) | Primary Cancer (%) | Histology (%) | Radiation dose | Study length (months) | NOS |
|---|---|---|---|---|---|---|---|---|
| Rades, 2011 | Surgery + WBI (n = 111) | ≤ 60:n = 56 > 60:n = 55 |
≤ 2.5 cm max diam: n = 53 > 2.5 cm max diam: n = 58 |
Breast cancer (22), Nonsmall cell lung cancer (49), Other (30) | Nonsmall cell lung cancer (49) | 5 × 4 Gy: n = 13 10 × 3 Gy: n = 61 20 × 2 Gy: n = 37 |
NA | 8 |
| WBI + RS (n = 41) | ≤ 60:n = 22 > 60: n = 19 |
≤ 2.5 cm max diam: n = 22 > 2.5 cm max diam: n = 19 | Breast cancer (24), Nonsmall cell lung cancer (44), Other (32) | Nonsmall cell lung cancer (44) | 5 × 4 Gy: n = 5 10 × 3 Gy: n = 22 20 × 2 Gy: n = 14 median RS dose: 21 Gy |
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| Roos, 2011 | Surgery + WBRT (n = 10) | Median: 58 Range: 43–72 | Median: 2.4 Range: 1–4 | Lung (50), Colorectal (20), Other (30) | NA | 30 Gy in 10 fractions | 54 | See Cochrane Risk of Bias (Supplementary Figure S1) |
| RS + WBRT (n = 11) | Median: 63 Range: 44–84 | Median: 1.7 Range: 0.7–3.6 | Lung (45), Colorectal (18), Other (36) | NA | Diameter ≤ 2 cm: 20 Gy Diameter = 2.1–3 cm: 18 Gy Diameter = 3.1–4 cm: 15 Gy |
64 | ||
| Jalvakar, 2010 | Surgery + WBRT (n = 24) | Median: 58 | Mean: 2.8 Median: 3.0 Range: 1.5–3.5 |
Lung (54), Breast (17), Colon (11), Esophagus (9), Kidney (3.5), Melanoma (3.3), Bladder (3.3) | Melanoma (3.3) | WBRT: 30 Gy per 10 fractions | 47 | 8 |
| Gamma knife (n = 11) | Median: 60 | Mean: 2.0 Median: 2.2 Range: 0.74–3.3 |
Median: 33.5 Gy | 43 | ||||
| Muacevic, 2008 | Surgery + WBRT (n = 33) | Mean ± SD: 58.3 ± 13.1 Median: 59 Range: 32–75 |
Mean ± SD: 2.4 ± 0.6 Median: 2 | Lung (36.4), GUT (12.1), GIT (9), Melanoma (15.2), Breast (15.2), Liver (3), Unknown (9) | Melanoma (15.2) | 2 Gy × 20 fractions | 45 | See Cochrane Risk of Bias (Supplementary Figure S1) |
| Gamma knife (n = 31) | Mean ± SD: 58.3 ± 13.1 Median: 59 Range: 32–75 |
Mean ± SD: 2.1 ± 0.8 Median: 2 | Lung (32.3), GUT (19.4), GIT (3.2), Melanoma (12.9), Breast (19.4), Liver (3.2), Unknown (9.7) | Melanoma (12.9) | Mean: 21 Gy Range: 14–27 Gy |
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| O’Neil, 2003 | Surgery + WBRT (n = 74) | Mean ± SD: 62 ± 12 Median: 63 IQR: 55–70 |
≤ 3.5 | Lung (54), GU (14), GI (9), Melanoma (8), Other (15) | Melanoma (8) | NA | 98 | 8 |
| Radiosurgery + WBRT (n = 23) | Mean ± SD: 61 ± 13 Median: 66 IQR: 51–71 |
Lung (48), GU (17), GI (13), Melanoma (4), Other (17) | Melanoma (4) | 108 | ||||
| Schöggl, 2000 | Surgery + WBRT (n = 66) | Median: 60 | < 3 cm max diam. median: 12 500 mm3 |
Lung (24), Breast (14), Melanoma (15), Renal cell carcinoma (3), Colorectal carcinoma (17), Adenocarcinoma (20), Other (7) | Melanoma (15), Adenocarcinoma (20) | postop: 30 Gy/10 days | 56 | 8 |
| Gamma-knife + WBRT (n = 67) | Median: 58 | < 3 cm max diam. median: 7800 mm3 |
Lung (52), Breast (11), Melanoma (4), Renal cell carcinoma (11), Colorectal carcinoma (6), Adenocarcinoma (9), Other(7) | Melanoma (4), Adenocarcinoma (9), Other | median SRS: 17 Gy 30 Gy/10 days | 44 | ||
| Muacevic, 1999 | Surgery + WBRT (n = 52) | Mean ± SD: 56.3 ± 10.6 Median: 59 Range: 17-74 |
Mean ± SD: 2.7 ± 0.7 Median: 3 | Lung (32.7), Genitourinary tract (19.2), Gastrointestinal tract (13.5), Melanoma (13.5), Breast (11.5), Other (1.9), Unknown (7.7) | Nonsmall cell bronchial carcinoma (32.7), Melanoma (13.5), Other (1.9), Unknown (7.7) | 50 Gy/5 weeks | survival: 30.25 local recur: 23.8 |
9 |
| Gamma knife (n = 56) | Mean ± SD: 59.3 ± 13.7 Median: 59 Range: 27-83 |
Mean ± SD: 2.07 ± 0.9 Median: 2 | Lung (30.4), Genitourinary tract (14.3), Gastrointestinal tract (5.4), Melanoma (28.6), Breast (14.3), Other (1.8), Unknown (5.4) | Nonsmall cell bronchial carcinoma (30.4), Melanoma (28.6), Other (1.8), Unknown (5.4) | Min dose mean: 21 Gy Max dose mean: 41 Gy |
survival: 26.25 local recur: 23.8 |
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| Mintz, 1996 | Surgery + WBRT (n = 41) | Mean ± SD: 58.9 ± 8.98 | Max ± SD: 2.54 ± 1.24 | Lung (56), Breast (4.9), Colon or rectum (24.4), Skin (4.9), Renal (2.4), Other (2.4), Unknown (4.9) | Nonsmall cell (56) | 3 × 10 Gy | 18 | See Cochrane Risk of Bias (Supplementary Figure S1) |
| WBRT (n = 43) | Mean ± SD: 58 ± 9.86 | Max ± SD: 2.96 ± 1.44 | Lung (53.6), Breast (19.5), Colon or rectum (7.3), Skin (4.9), Renal (4.9), Head and neck (2.4), Other (7.3), Unknown (4.9) | Nonsmall cell (53.6) | 3 × 10 Gy |
Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of retrospective observational studies. NOS scores ≥ 6 are considered to be high quality. Abbreviations: NA, not available; SD, standard deviation; IQR, interquartile range; WBI, whole-brain irradiation; WBRT, whole-brain radiotherapy; RS, radiosurgery.