Table 1 The main characteristics of the included studies
From: Dose-effect relationship of linear accelerator based stereotactic radiotherapy for brain metastases
First Authors (Publication Year) | Country | Treatment Time | N. Patients (Proportion of Male) | N. Metastases | Median or mean Age | Most Common Histology | Tumour Size | Extracranial Disease Control (%) | GTV to PTV margin (mm) | Nominal/Peripheral/Central Dose (Gy) | Median No. of Fractions | Nominal/Peripheral/Central BED10 (Gy) | Treatment technology | Follow-up (months) | LC at 6 months (%) | LC at 12 months (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pirzkall (1998) # [13] | Germany | 1984–1997 | 158 (72%) | NR | 57.4 | NSCLC, Renal, Melanoma | 20 (3–38) mm | NR | 1–2 | 20/20/25 | 1 | 60/60/87.5 | 15MV, 9 NCA with CSC or manually driven MLC | NR | NR | 89 |
Matsuo (1999) # [14] | Japan | 1993–1998 | 51 (50%) 41 | NR | 60.2 | NSCLC, SCLC, Breast, Colon, Liver, Sarcoma, Melanoma | NR | 42 | NR | 20/20/25 25/25/50 | 1 | 60/60/87.5 87.5/87.5/300 | 10MV, 6–29 mm CSC in diameter | 11 (1–44) | 95 100 | 85 100 |
Aoyama (2003) [15] | Japan | 1995–2000 | 87 (62%) | 159 | 65 | Lung cancer, Colon cancer, Breast cancer | 3.3 (0.006–48.3) cc | 45 | 2 | 35/32/35 | 4 | 65.6/57.6/65.6 | 6 MV or 10 MV, thermos-shell | 6.3 (0.2–60.3) | 85 | 81 |
Noel (2003) # [16] | France | 1994–2002 | 34 (56%) | 51 | 59 | Adenocarcinoma, Squamous cell carcinoma | 2.0 (0.1–16.5) cc | 68 | 1 | 14/14/20.2 | 1 | 33.6/33.6/61.0 | Leksell stereotactic head frame, 10MV, | 29 (18–36) | 90 | 78 |
Nakayama (2004) [17] | Japan | 1999–2002 | 15 (73%) | 20 | 69.5 | NSCLC | NR | NR | 2–3 | 40/40/44.4 | 4 | 80/80/93.7 | 10MV, 5 to 35 mm CSC | 21 (2–34) | 100 | 95 |
Narayana (2007) # [18] | U. S. | 2004–2005 | 20 (45%) | 20 | 60 | Lung, Melanoma, Renal, Breast, Gastrointestinal | 35 (20–50) mm | NR | 3 | 30/30/- | 5 | 48/48/- | 6MV | 10 (1–18) | 90 | 70 |
Lutterbach (2008) # [19] | Germany | 1994–2001 | 101 (49%) | 155 | 59 | Lung, Breast, kidney, Melanoma, Gastrointestinal | 21 (4–30) mm | 66.3 | 2 | 18/18/22.5 | 1 | 50.4/50.4/73.1 | 6MV, 6 NCA, CSC | NR | 93 | 91 |
Fokas (2010) [20] | Germany | 1996–2006 | 51 (70%) | NR | NR | Renal Cell Cancer | NR | NR | 2–5 | 19/19/23.8 | 1 | 55.1/55.1/80.2 | 6MV, 7–11 noncoplanar static beams | 9–95 | NR | 81 |
Nath (2010) [21] | U. S. | 2005–2008 | 20 (38%) | NR | 53 | Breast, lung, Melanoma | NR | NR | 1 | 18/18/20 | 1 | 50.4/50.4/60 | 6MV, 1000MU/min, dynamic MLC, 9–11 beams of fixed gantry | 3 (0.2–21.3) | 96 | 83 |
Saitoh (2010) [22] | Japan | 2003–2006 | 49 (69%) | 78 | NR | Lung | NR | 36.7 | 3 | 42/37.8/42 | 3 | 100.8/85.4/100.8 | HeadFix, 6MV, 6–12 NCSB | 17.4 (0.4–60.5) | NR | 86 |
Fokas (2012) [23] | Germany | 2000–2009 | 138 (43%) | NR | NR | NSCLC, Urogenital, Gastrointestinal | 1.87 (0.03–11.17) cc | NR | 2 | 20.0/20.0/- | 1 | 60/60/- | Head mask, 6MV, 11–14 NCSB | 28 (2.1–77) | 84 | 73 |
Feuvret (2014) [24] | France | 2007–2009 | 12 (50%) | 12 | 57 | Lung cancer, Breast cancer, Miscellaneous | 32.61 (19.1-65.56) cc | 67 | 2 | 33.0/23.1/33.0 | 3 | 69.3/40.9/69.3 | 6MV, 7 or 14 fixed conformal beams or 5 DCA | 17.5 (2-61.3) | 100 | 100 |
Yang (2014) [25] | U. S. | 2000–2012 | 136 (NR) | 186 | 58 | Breast | 9 (2–34) mm | 46.3 | 2 | 21/21/26.3 | 1 | 65.1/65.1/95.2 | Brown-roberts-Wells frame, 8–12 NCSB, 3-mm leaves MLC | 23.4 (2.3-140.2) | 95 | 90 |
Minniti (2016) # [26] | Italy | 2008–2014 | 151 (49%) 138 (50%) | 179 164 | 64 62 | NSCLC, Breast cancer, Colon carcinoma, Melanoma | 12.2 (4.4–32) cc 17.9 (5.6–54) cc | 25 28 | 1–2 | 18.0/18.0/21.2 27.0/27.0/31.8 | 1 3 | 50.4/50.4/66.1 51.3/51.3/65.5 | 6–15 NCA or fixed beams | 10 | 94 97 | 77 90 |
Navarria (2016) [27] | Italy | 2011–2015 | 51 (62%) 51 | 51 51 | 61 | NSCLC, Breast cancer, Melanoma | 33.7 (9.2-122.3) cc | NR | 3 | 27/27/27 32/32/32 | 3 4 | 51.3/51.3/51.3 57.6/57.6/57.6 | VMAT | 14 (3–53) | 100 100 | 100 91 |
Aoki (2021) [28] | Japan | 2016–2018 | 13 (77%) | 113 | 67 | Lung | 2.0 ± 2.7 cc | NR | 1 | 24/24/ - | 1 | 81.6/81.6/- | 6MV, 1000 MU/min, Arcs | 17 ± 8.8 | 88 | 88 |
Badloe (2021) [29] | The Netherlands | 2015–2016 2010–2012 | 37 (38%) 84 (51%) | NR | 64 | Lung, Breast, Melanoma, Renal cell, Colorectal | 4.7 cc 10.9 cc | NR | 0 2 | 21/21/27.6 18/18/23.6 | 1 1 | 65.1/65.1/103.8 50.4/50.4/79.3 | 6MV, NCA | 31.2 (27.6–34.8) 79.2 (72-91.2) | 97 89 | 84 87 |
Vigneau (2022) [30] | France | 2016–2018 | 44 (57%) | 61 | 64 | NR | 18.5 (4–56) mm | NR | 1 | 23.1/23.1/33 | 3 | 40.9/40.9/69.3 | THM, coplanar VMAT | 31.9 | 93.2 | 90 |
Piras (2022) [31] | Italy | 2016–2020 | 41 (46%) | 57 | 68 | NSCLC, Breast, Colorectal, SCLC, Melanoma | 1.8 (0.1–22.4) cc | NR | 3 | 30/30/31.6 | 5 | 48/48/51.3 | THM | 6 (1–21) | 54.4 | NR |