Stereotactic radiosurgery for patients with small-cell lung cancer brain metastases
A partir d'une revue systématique de la littérature publiée jusqu'en mars 2022 (31 études, 35 091 patients atteints d'un cancer du poumon à petites cellules), cette méta-analyse évalue l'efficacité, du point de vue de la survie globale, d'un traitement par radiochirurgie stéréotaxique par rapport à une radiothérapie du cerveau entier chez les patients présentant un risque élevé de métastases intracrâniennes
Despite the continuous implementation of stereotactic radiosurgery (SRS) for patients with limited (≤4) brain metastases from various solid tumours and despite the increasing evidence of neurocognitive toxicity from whole brain radiotherapy (WBRT), patients with brain metastases from small-cell lung cancer (SCLC) are still considered typical candidates for WBRT. International guidelines and surveys on care patterns still regard WBRT as a standard of care for this setting in clinical practice. Several studies in various cancers have shown that postoperative SRS instead of additional WBRT can be associated with high control and survival rates and could preserve neurocognitive functioning; therefore, SRS has replaced WBRT as the standard of care for patients with limited brain metastases from most solid tumours, and its safety and efficacy is suggested for as many as ten targetable lesions.
The Lancet Oncology , commentaire, 2021