Overall survival: higher‐dose WBRT vs control (3000 cGy/10 daily fractions)No. of participants: 846(4 RCTs) · patients with newly diagnosed multiple brain metastases
Altered WBRT fractionation schedules probably leads to higher overall survival: lower‐dose WBRT vs control WBRT (3000 cGy/10 daily… compared with WBRT control (moderate certainty).
2 findings from 1 review
HR 1.21 [1.04, 1.4]
Studies not reported
Moderate
HR 0.97 [0.83, 1.12]
Studies not reported
Moderate
Brain tumour response rates: complete response (CR) and partial response (PR) combinedNo. of participants: 847(6 RCTs) · patients with newly diagnosed multiple brain metastases
WBRT with radiosensitisers (radiosen) showed no clear difference in brain tumour response rates: complete response (CR) and partial… compared with WBRT alone (high certainty).
1 finding from 1 review
OR 0.84 [0.63, 1.11]
Studies not reported
High
Adverse effectsNo. of participants: 1754(9 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
High
Quality of lifeNo. of participants: 271(2 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
Moderate
Symptom controlNo. of participants: 1814(3 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
Moderate
Overall survivalNo. of participants: 2631(8 RCTs) · patients with newly diagnosed multiple brain metastases
WBRT and radiosurgery showed no clear difference in overall survivalNo. of participants: 358(2 RCTs) compared with WBRT (moderate certainty).
1 finding from 1 review
HR 0.61 [0.27, 1.39]
Studies not reported
Moderate
1‐Year overall brain control ratesNo. of participants: 400(3 RCTs) · patients with newly diagnosed multiple brain metastases
WBRT and radiosurgery leads to lower 1‐Year overall brain control ratesNo. of participants: 400(3 RCTs) compared with WBRT (high certainty).
1 finding from 1 review
HR 0.39 [0.25, 0.6]
Studies not reported
High
Adverse effectsNo. of participants: 1754(9 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
High
Intracranial progression‐free durationNo. of participants: 400(3 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
High
Overall survivalNo. of participants: 2631(8 RCTs) · patients with newly diagnosed multiple brain metastases
Radiosurgery alone showed no clear difference in overall survivalNo. of participants: 403(3 RCTs) compared with WBRT and radiosurgery (moderate certainty).
1 finding from 1 review
HR 1 [0.8, 1.25]
Studies not reported
Moderate
1‐Year radiosurgery‐targeted lesion controlNo. of participants: 602(4 RCTs) · patients with newly diagnosed multiple brain metastases
Radiosurgery alone leads to higher 1‐Year radiosurgery‐targeted lesion controlNo. of participants:… compared with WBRT and radiosurgery (high certainty).
1 finding from 1 review
HR 2.73 [1.87, 3.99]
Studies not reported
High
1‐Year distant brain controlNo. of participants: 602(4 RCTs) · patients with newly diagnosed multiple brain metastases
Radiosurgery alone leads to higher 1‐Year distant brain controlNo. of participants: 602(4 RCTs) compared with WBRT and radiosurgery (high certainty).
1 finding from 1 review
HR 2.34 [1.73, 3.18]
Studies not reported
High
Adverse effectsNo. of participants: 1754(9 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
High
NeurocognitionNo. of participants: 403(3 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
Moderate
Neurological functionNo. of participants: 544(3 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
Moderate
Quality of lifeNo. of participants: 271(2 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
Moderate
Overall survival: WBRT 4000 cGy/20 fractions BID vs control WBRT (2000 cGy/4‐5 daily fractions)No. of participants: 203(2 RCTs) · patients with newly diagnosed multiple brain metastases
Altered WBRT fractionation schedules showed no clear difference in overall survival: WBRT 4000 cGy/20 fractions BID vs control WBRT… compared with WBRT control (moderate certainty).
1 finding from 1 review
HR 1.18 [0.89, 1.56]
Studies not reported
Moderate
Adverse effectsNo. of participants: 1754(9 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
High
Symptom controlNo. of participants: 1814(3 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
Moderate
Overall brain controlNo. of participants: 203(2 RCTs) · patients with newly diagnosed multiple brain metastases
1 finding from 1 review
no estimate extracted
Studies not reported
Moderate