Int J Radiat Oncol Biol Phys 2004, 59: 528–537.CrossRefPubMed Competing interests The authors declare that they have no competing interests. Authors’ contributions FA conceived of the study, coordinated the study, helped acquisition of data, performed the statistical analysis and draft the manuscript. SB has performed treatment plans, participated in acquisition of data and helped to draft the manuscript. YO has performed treatment plans, participated in acquisition of data and helped to draft the manuscript. UN has been helped acquisition of data and drafting the manuscript. AD has been helped acquisition and analysis of data and helped to draft

the manuscript. MA have participated in the conception and design of the study and revising the manuscript critically for important intellectual EGFR inhibitor content. All authors read and approved the final manuscript.”
“Background Foretinib in vivo Brain metastases represent Salubrinal a sizeable health care problem. An estimated 20–40% of cancer patients will develop multiple brain metastases [1], and 30–40% will develop a single metastasis [2] during the course of their illness. Therapeutical approaches to brain metastases include surgery, whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), and chemotherapy. Treatment decisions must take into account clinical prognostic factors in order to maximize survival and neurological

function whilst avoiding unnecessary treatments [3–11]. Radiosensitizers are chemical or pharmacologic agents that increase the lethal effects of radiation if administered with it. In an attempt to improve outcomes, studies have examined the use of whole brain radiotherapy combined to radiosensitizers [12–18]. There are many chemicals capable of rendering cells or tissue more sensitive to radiation, but it only those drugs for which there is a differential

response between the tumor and dose-limiting normal tissue that may be of benefit radiotherapy. Dozens of clinical trials have been performed, most of which have been inconclusive or have shown results with a borderline results [19–27]. Tsao et al. has presented the results of five randomized controlled trials [5, 19–23] that examined the use of radiosensitizers in addition to WBRT. However, none of second those trials detected a benefit in terms of overall survival or brain response (CR + PR). Moreover, this meta-analysis did not evaluate the incidence of adverse effects, the differences on quality of life or the neurocognitive progression. Since its publication, other studies have been published, investigating new radiosensitizers. So, the aim of our meta-analysis is to evaluate the outcomes and adverse effects of the randomized clinical trials in the treatment of cerebral metastases using radiosensitizer combined to WBRT.