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01-03-2021 | Metastasis | Clinical

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

Authors: Pierre-Yves Borius, Jean Régis, Alexandre Carpentier, Michel Kalamarides, Charles Ambroise Valery, Igor Latorzeff

Published in: Cancer and Metastasis Reviews | Issue 1/2021

Abstract

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.

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Title: Safety of radiosurgery concurrent with systemic therapy (chemotherapy, targeted therapy, and/or immunotherapy) in brain metastases: a systematic review
Authors: Pierre-Yves Borius
Jean Régis
Alexandre Carpentier
Michel Kalamarides
Charles Ambroise Valery
Igor Latorzeff
Publication date: 01-03-2021
Publisher: Springer US
Keywords: Metastasis
Melanoma
Melanoma
Systemic Therapy
Radiotherapy
Targeted Therapy
Lapatinib
Cytostatic Therapy
Published in: Cancer and Metastasis Reviews / Issue 1/2021
Print ISSN: 0167-7659
Electronic ISSN: 1573-7233
DOI: https://doi.org/10.1007/s10555-020-09949-9

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