Safety of radiosurgery concurrent with systemic therapy (chemotherapy, targeted therapy, and/or immunotherapy) in brain metastases: a systematic review.

Immunotherapy Radiosurgery Safety Systemic therapy Targeted therapy Toxicity

Journal

Cancer metastasis reviews
ISSN: 1573-7233
Titre abrégé: Cancer Metastasis Rev
Pays: Netherlands
ID NLM: 8605731

Informations de publication

Date de publication:
03 2021
Historique:
received: 13 11 2020
accepted: 15 12 2020
pubmed: 5 1 2021
medline: 26 11 2021
entrez: 4 1 2021
Statut: ppublish

Résumé

Stereotactic radiosurgery (SRS) is a standard option for brain metastases (BM). There is lack of consensus when patients have a systemic treatment, if a washout is necessary. The aim of this review is to analyze the toxicity of SRS when it is concurrent with chemotherapies, immunotherapy, and/or targeted therapies. From Medline and Embase databases, we searched for English literature published up to April 2020 according to the PRISMA guidelines, using for key words the list of the main systemic therapies currently in use And "radiosurgery," "SRS," "GKRS," "Gamma Knife," "toxicity," "ARE," "radiation necrosis," "safety," "brain metastases." Studies reporting safety or toxicity with SRS concurrent with systemic treatment for BM were included. Of 852 abstracts recorded, 77 were included. The main cancers were melanoma, lung, breast, and renal carcinoma. These studies cumulate 6384 patients. The median SRS dose prescription was 20 Gy [12-30] .For some, they compared a concurrent arm with a non-concurrent or a SRS-alone arm. There were no skin toxicities, no clearly increased rate of bleeding, or radiation necrosis with significant clinical impact. SRS combined with systemic therapy appears to be safe, allowing the continuation of treatment when brain SRS is considered.

Identifiants

pubmed: 33392851
doi: 10.1007/s10555-020-09949-9
pii: 10.1007/s10555-020-09949-9
doi:

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

341-354

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Auteurs

Pierre-Yves Borius (PY)

Neurosurgery Department, Pitié Salpêtrière Sorbonne University Hospital, Paris, France. Pierre-yves.borius@aphp.fr.

Jean Régis (J)

Aix-Marseille Université, Institut de Neuroscience des Systèmes, Functional Neurosurgery and Radiosurgery Department, Hôpital de la Timone, APHM, Marseille, France.

Alexandre Carpentier (A)

Neurosurgery Department, Pitié Salpêtrière Sorbonne University Hospital, Paris, France.

Michel Kalamarides (M)

Neurosurgery Department, Pitié Salpêtrière Sorbonne University Hospital, Paris, France.

Charles Ambroise Valery (CA)

Neurosurgery Department, Pitié Salpêtrière Sorbonne University Hospital, Paris, France.

Igor Latorzeff (I)

Département de radiothérapie-oncologie, bâtiment Atrium, Clinique Pasteur, 1, rue de la Petite-Vitesse, 31300, Toulouse, France.

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