Eight RCTs (n=2,317 reported in the text, n=2,753 based on Table 1) were included in meta-analyses. Sample size ranged from 58 to 554. Study quality was not reported.
Compared with whole brain radiotherapy alone, whole brain radiotherapy with radiosensitizer was not significantly associated with an improvement in overall survival at six months (OR 1.03, 95% CI 0.84 to 1.25; seven RCTs), local brain tumour response (OR 0.8, 95% CI 0.5 to 1.03; four RCTs) and central nervous system progression (OR 1.1, 95% CI 0.9 to 1.3; four RCTs)
No significant heterogeneity was observed in the outcomes of overall survival and central nervous system progression; the result of statistical heterogeneity assessment for the outcome of local brain tumour response was not presented.
Seven RCTs reported treatment-related serious adverse events. One RCT reported that 11% of efaproxiral-treated patients had grade three adverse event of hypoxemia. One RCT reported that the rate of patients who experienced Grade three to four adverse events in the group of whole brain radiotherapy with thalidomide was significantly higher than the group of whole brain radiotherapy alone (p<0.0001). One RCT reported three fatal toxicities in 34 patients who received whole brain radiotherapy with bromodeoxyuridine.
Results of quality of life and neurocognitive progression were reported.