Stereotactic radiotherapy for brain metastases of non-small cell lung cancer: A comprehensive review

Table 1 The use of stereotactic radiotherapy to treat brain metastasis of lung cancer and its effectiveness compared with whole-brain radiotherapy

Ref.	Objective	Dosage	Key findings	Effectiveness	Toxicity	Concluding remarks
Luo et al[97]	Local and cerebral control in NSCLC patients treated with CyberKnife™ SRT	27 Gy in three fractions (69%), 18–25 Gy in one fraction (18%), 30 Gy in five fractions (9%)	Local control rate = 78.7%, cerebral control rate = 43%, median overall survival = 10.1 months	Effective for local control, minimal toxicity	Acute toxicity = 17%, severe toxicity = 2%	Suitable for patients with few BMs, close follow-up is needed
Fessart et al[99]	Survival predictors in patients with lung cancer and BM	Single 20-Gy fraction for SRT, 7–10 Gy/fraction for HFSRT	Disease control rate = 84%, median overall survival = 6.1 months	Effective with better control than WBRT	Grade III–IV toxicity = 4%	Well-tolerated, patient selection is key
Guo et al[100]	Palliative RT for BM and quality of life	WBRT = 30 Gy for 10 fractions, SRS = 20 Gy single fraction	Response rate = 50%–75%, neurological improvement rate = 75%	Improves quality of life, better than WBRT alone	Short term: Neurological symptoms; long term: Memory loss	Treatment should be individualized according to patients’ conditions
Gunnarsson et al[101]	Effectiveness of SRT in patients with lung cancer and BM	BED 10 SRT ≥ 50 Gy	Median overall survival = 19 months	Effective with controlled extracranial disease	No marked toxicity difference	SRT is effective, particularly with stable extracranial disease
Hashmi et al[102]	Cognitive deterioration in SRS vs SRS + WBRT patients	SRS = 20–24 Gy, SRS + WBRT = 18–20 Gy (SRS) + 30 Gy (WBRT)	Cognitive deterioration: 63.5% (SRS) vs 91.7% (SRS + WBRT), median survival = 10.4 months (SRS), 7.4 months (SRS + WBRT)	SRS alone results in less cognitive decline	Cognitive deterioration	SRS preferred for minimizing cognitive decline without impacting survival

NSCLC: Non-small cell lung cancer; BM: Brain metastasis; SRT: Stereotactic radiotherapy; SRS: Stereotactic radiosurgery; WBRT: Whole-brain radiotherapy; HFSRT: Hypofractionated stereotactic radiotherapy; BED: Biologically effective dose.