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Review
. 2024 Oct 21;16(20):3551.
doi: 10.3390/cancers16203551.

Stereotactic Radiosurgery for Intracranial Breast Metastases: A Systematic Review and Meta-Analysis

Neil D Almeida  1   2 , Cathleen Kuo  1   2 , Tyler V Schrand  3 , Julia Rupp  2 , Venkatesh S Madhugiri  1 , Victor Goulenko  1   2 , Rohil Shekher  1 , Chirag Shah  4 , Dheerendra Prasad  1   2   5
Affiliations
Review

Stereotactic Radiosurgery for Intracranial Breast Metastases: A Systematic Review and Meta-Analysis

Neil D Almeida et al. Cancers (Basel). .

Abstract

Background/objectives: To determine the impact of stereotactic radiosurgery on outcomes of metastatic breast cancer with intracranial metastases.

Methods: We systematically searched the PubMed and EMBASE databases for studies published between 1 January 1990 and 1 August 2024. Primary research articles evaluating the outcomes of stereotactic radiosurgery on intracranial metastases from breast cancer were included. Adverse events were defined as leptomeningeal disease, radiation necrosis, seizure, and headache. The pooled estimate was calculated using the DerSimonian and Laird approach.

Results: Sixteen studies encompassing 1228 patients met the inclusion criteria. Our analysis revealed a median survival duration of 13.1 ± 3.8 months and a pooled 1-year overall survival rate of 53.1% after SRS treatment. There was a 29% local recurrence rate at 1 year and a 35% overall distant recurrence rate. In addition, our analysis found a relatively low rate of acute adverse events at 15.5%.

Conclusions: SRS demonstrates promising efficacy and safety in managing intracranial metastases from breast cancer, with a favorable toxicity profile.

Keywords: Gamma Knife radiosurgery; breast cancer; intracranial metastasis; stereotactic radiosurgery.

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Conflict of interest statement

The author Chirag Shah reports Consultant Impedimed, PreludeDX, and Videra Surgical as conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study selection flow chart.
Figure 2
Figure 2
Meta-analysis of 1-year overall survival shown as a forest plot. Plots weighted for sample size show the 1-year overall survival rate ranging from 41.36% to 68.03%. CI, confidence interval [3,14,15,18,19,20,21,22,24,27].
Figure 3
Figure 3
Meta-analysis of 1-year progression-free survival shown as a forest plot. Plots weighted for sample size show the 1-year progression-free survival rate ranging from 42.20% to 79.74%. CI, confidence interval [3,19,23,27].
Figure 4
Figure 4
Meta-analysis of 1-year local recurrence rate shown as a forest plot. Plots weighted for sample size show the 1-year local recurrence rate ranging from 16.65% to 51.96%. CI, confidence interval [17,18,21,22,24].
Figure 5
Figure 5
Meta-analysis of overall local recurrence rate shown as a forest plot. Plots weighted for sample size show the overall local recurrence rate ranging from 7.29% to 23.98%. CI, confidence interval [15,20,21,22,23,24,25].
Figure 6
Figure 6
Meta-analysis of overall distant recurrence rate shown as a forest plot. Plots weighted for sample size show the distant recurrence rate ranging from 30.69% to 39.89%. CI, confidence interval [15,18,20,21,22,24,25].
Figure 7
Figure 7
Meta-analysis of acute adverse event rate shown as a forest plot. Plots weighted for sample size show the acute adverse event rate ranging from 8.77% to 27.33%. CI, confidence interval [15,19,20,23,24,27].
Figure 8
Figure 8
Meta-analysis of neurological death shown as a forest plot. Plots weighted for sample size show the neurological death rate ranging from 13.63% to 34.17%. CI, confidence interval [3,4,14,23,24,27].
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