Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis

Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment pa...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Dharnipragada, Rajiv [verfasserIn] Dusenbery, Kathryn [verfasserIn] Ferreira, Clara [verfasserIn] Sharma, Mayur [verfasserIn] Chen, Clark C. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Adjuvant radiosurgery Brain metastasis Neoadjuvant radiosurgery Postoperative radiosurgery Preoperative radiosurgery Resection

Übergeordnetes Werk:	Enthalten in: World neurosurgery - Amsterdam : Elsevier, 2010, 182, Seite 35-41
Übergeordnetes Werk:	volume:182 ; pages:35-41

DOI / URN:	10.1016/j.wneu.2023.10.131

Katalog-ID:	ELV067100589

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100	1		\|a Dharnipragada, Rajiv \|e verfasserin \|0 (orcid)0000-0002-2522-3433 \|4 aut
245	1	0	\|a Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis
264		1	\|c 2023
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520			\|a Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM.
650		4	\|a Adjuvant radiosurgery
650		4	\|a Brain metastasis
650		4	\|a Neoadjuvant radiosurgery
650		4	\|a Postoperative radiosurgery
650		4	\|a Preoperative radiosurgery
650		4	\|a Resection
700	1		\|a Dusenbery, Kathryn \|e verfasserin \|4 aut
700	1		\|a Ferreira, Clara \|e verfasserin \|4 aut
700	1		\|a Sharma, Mayur \|e verfasserin \|0 (orcid)0000-0001-6481-7819 \|4 aut
700	1		\|a Chen, Clark C. \|e verfasserin \|4 aut
773	0	8	\|i Enthalten in \|t World neurosurgery \|d Amsterdam : Elsevier, 2010 \|g 182, Seite 35-41 \|h Online-Ressource \|w (DE-627)615134904 \|w (DE-600)2530041-6 \|w (DE-576)321461150 \|x 1878-8769 \|7 nnns
773	1	8	\|g volume:182 \|g pages:35-41
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936	b	k	\|a 44.90 \|j Neurologie \|q VZ
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publishDate	2023
allfields	10.1016/j.wneu.2023.10.131 doi (DE-627)ELV067100589 (ELSEVIER)S1878-8750(23)01537-1 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Dharnipragada, Rajiv verfasserin (orcid)0000-0002-2522-3433 aut Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM. Adjuvant radiosurgery Brain metastasis Neoadjuvant radiosurgery Postoperative radiosurgery Preoperative radiosurgery Resection Dusenbery, Kathryn verfasserin aut Ferreira, Clara verfasserin aut Sharma, Mayur verfasserin (orcid)0000-0001-6481-7819 aut Chen, Clark C. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 182, Seite 35-41 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:182 pages:35-41 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 Neurologie VZ AR 182 35-41
spelling	10.1016/j.wneu.2023.10.131 doi (DE-627)ELV067100589 (ELSEVIER)S1878-8750(23)01537-1 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Dharnipragada, Rajiv verfasserin (orcid)0000-0002-2522-3433 aut Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM. Adjuvant radiosurgery Brain metastasis Neoadjuvant radiosurgery Postoperative radiosurgery Preoperative radiosurgery Resection Dusenbery, Kathryn verfasserin aut Ferreira, Clara verfasserin aut Sharma, Mayur verfasserin (orcid)0000-0001-6481-7819 aut Chen, Clark C. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 182, Seite 35-41 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:182 pages:35-41 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 Neurologie VZ AR 182 35-41
allfields_unstemmed	10.1016/j.wneu.2023.10.131 doi (DE-627)ELV067100589 (ELSEVIER)S1878-8750(23)01537-1 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Dharnipragada, Rajiv verfasserin (orcid)0000-0002-2522-3433 aut Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM. Adjuvant radiosurgery Brain metastasis Neoadjuvant radiosurgery Postoperative radiosurgery Preoperative radiosurgery Resection Dusenbery, Kathryn verfasserin aut Ferreira, Clara verfasserin aut Sharma, Mayur verfasserin (orcid)0000-0001-6481-7819 aut Chen, Clark C. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 182, Seite 35-41 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:182 pages:35-41 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 Neurologie VZ AR 182 35-41
allfieldsGer	10.1016/j.wneu.2023.10.131 doi (DE-627)ELV067100589 (ELSEVIER)S1878-8750(23)01537-1 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Dharnipragada, Rajiv verfasserin (orcid)0000-0002-2522-3433 aut Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM. Adjuvant radiosurgery Brain metastasis Neoadjuvant radiosurgery Postoperative radiosurgery Preoperative radiosurgery Resection Dusenbery, Kathryn verfasserin aut Ferreira, Clara verfasserin aut Sharma, Mayur verfasserin (orcid)0000-0001-6481-7819 aut Chen, Clark C. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 182, Seite 35-41 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:182 pages:35-41 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 Neurologie VZ AR 182 35-41
allfieldsSound	10.1016/j.wneu.2023.10.131 doi (DE-627)ELV067100589 (ELSEVIER)S1878-8750(23)01537-1 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Dharnipragada, Rajiv verfasserin (orcid)0000-0002-2522-3433 aut Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM. Adjuvant radiosurgery Brain metastasis Neoadjuvant radiosurgery Postoperative radiosurgery Preoperative radiosurgery Resection Dusenbery, Kathryn verfasserin aut Ferreira, Clara verfasserin aut Sharma, Mayur verfasserin (orcid)0000-0001-6481-7819 aut Chen, Clark C. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 182, Seite 35-41 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:182 pages:35-41 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 Neurologie VZ AR 182 35-41
language	English
source	Enthalten in World neurosurgery 182, Seite 35-41 volume:182 pages:35-41
sourceStr	Enthalten in World neurosurgery 182, Seite 35-41 volume:182 pages:35-41
format_phy_str_mv	Article
bklname	Neurologie
institution	findex.gbv.de
topic_facet	Adjuvant radiosurgery Brain metastasis Neoadjuvant radiosurgery Postoperative radiosurgery Preoperative radiosurgery Resection
dewey-raw	610
isfreeaccess_bool	false
container_title	World neurosurgery
authorswithroles_txt_mv	Dharnipragada, Rajiv @@aut@@ Dusenbery, Kathryn @@aut@@ Ferreira, Clara @@aut@@ Sharma, Mayur @@aut@@ Chen, Clark C. @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
hierarchy_top_id	615134904
dewey-sort	3610
id	ELV067100589
language_de	englisch
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Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). 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author	Dharnipragada, Rajiv
spellingShingle	Dharnipragada, Rajiv ddc 610 bkl 44.90 misc Adjuvant radiosurgery misc Brain metastasis misc Neoadjuvant radiosurgery misc Postoperative radiosurgery misc Preoperative radiosurgery misc Resection Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis
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topic_title	610 VZ 44.90 bkl Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis Adjuvant radiosurgery Brain metastasis Neoadjuvant radiosurgery Postoperative radiosurgery Preoperative radiosurgery Resection
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topic_unstemmed	ddc 610 bkl 44.90 misc Adjuvant radiosurgery misc Brain metastasis misc Neoadjuvant radiosurgery misc Postoperative radiosurgery misc Preoperative radiosurgery misc Resection
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title	Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis
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title_full	Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis
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title_sort	preoperative versus postoperative radiosurgery of brain metastases: a meta-analysis
title_auth	Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis
abstract	Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM.
abstractGer	Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM.
abstract_unstemmed	Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM.
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title_short	Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis
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up_date	2024-07-06T20:05:35.762Z
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fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">ELV067100589</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240218093041.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240218s2023 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1016/j.wneu.2023.10.131</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)ELV067100589</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(ELSEVIER)S1878-8750(23)01537-1</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rda</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">VZ</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.90</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Dharnipragada, Rajiv</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0002-2522-3433</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Objective: While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval].Results: We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5–17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9–13.7] and 17.5% [15.1–19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6–6.2], relative to post-SRS, 12.3% [8.9–15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1–9.6] and 8.9% [6.3–11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8–64.6] and 60.5% [56.9–64.0] for pre- and post-SRS studies (P = 0.974).Conclusions: This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Adjuvant radiosurgery</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Brain metastasis</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Neoadjuvant radiosurgery</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Postoperative radiosurgery</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Preoperative radiosurgery</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Resection</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Dusenbery, Kathryn</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ferreira, Clara</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Sharma, Mayur</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0001-6481-7819</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Chen, Clark C.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">World neurosurgery</subfield><subfield code="d">Amsterdam : Elsevier, 2010</subfield><subfield code="g">182, Seite 35-41</subfield><subfield code="h">Online-Ressource</subfield><subfield code="w">(DE-627)615134904</subfield><subfield code="w">(DE-600)2530041-6</subfield><subfield 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Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis

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