Evidence map›Paper›PMID 26108659›Full record

ArticleJournal of neuro-oncology2015

Salvage whole brain radiotherapy or stereotactic radiosurgery after initial stereotactic radiosurgery for 1-4 brain metastases.

Yufei Liu, Brian M Alexander, Yu-Hui Chen, Margaret C Horvath, Ayal A Aizer, Elizabeth B Claus, Ian F Dunn, Alexandra J Golby, Mark D Johnson, Scott Friesen and 4 more

Abstract read
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In one paragraph

Article in Journal of neuro-oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.7field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Yufei LiuDepartment of Radiation Oncology, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA.
Brian M AlexanderDepartment of Radiation Oncology, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA.
Yu-Hui ChenDepartment of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
Margaret C HorvathDepartment of Radiation Oncology, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA.
Ayal A AizerDepartment of Radiation Oncology, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA.
Elizabeth B ClausDepartment of Neurosurgery, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA, USA.
Ian F DunnDepartment of Neurosurgery, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA, USA.
Alexandra J GolbyDepartment of Neurosurgery, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA, USA.
Mark D JohnsonDepartment of Neurosurgery, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA, USA.
Scott FriesenDepartment of Radiation Oncology, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA.
Edward G MannarinoDepartment of Radiation Oncology, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA.
Matthew WagarDepartment of Radiation Oncology, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA.
Fred L HackerDepartment of Radiation Oncology, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA.
Nils D ArvoldDepartment of Radiation Oncology, Dana-Farber/Brigham & Women's Cancer Center, Harvard Medical School, 75 Francis Street, ASB1-L2, Boston, MA, 02115, USA. narvold@partners.org.
Dana-Farber Brigham Cancer Center · USHarvard University · USDana-Farber Cancer Institute · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with limited brain metastases are often candidates for stereotactic radiosurgery (SRS) or whole brain radiotherapy (WBRT). Among patients who receive SRS, the likelihood and timing of salvage WBRT or SRS remains unclear. We examined rates of salvage WBRT or SRS among 180 patients with 1-4 newly diagnosed brain metastases who received index SRS from 2008-2013. Competing risks multivariable analysis was used to examine factors associated with time to WBRT. Patients had non-small cell lung (53 %), melanoma (23 %), breast (10 %), renal (6 %), or other (8 %) cancers. Median age was 62 years. Patients received index SRS to 1 (60 %), 2 (21 %), 3 (13 %), or 4 (7 %) brain metastases. Median survival after SRS was 9.7 months (range, 0.3-67.6 months). No further brain-directed radiotherapy was delivered after index SRS in 55 % of patients. Twenty-seven percent of patients ever received salvage WBRT, and 30 % ever received salvage SRS; 12 % of patients received both salvage WBRT and salvage SRS. Median time to salvage WBRT or salvage SRS were 5.6 and 6.1 months, respectively. Age ≤60 years (adjusted hazard ratio [AHR] = 2.80; 95 % CI 1.05-7.51; P = 0.04) and controlled/absent extracranial disease (AHR = 6.76; 95 % CI 1.60-28.7; P = 0.01) were associated with shorter time to salvage WBRT. Isolated brain progression caused death in only 11 % of decedents. In summary, most patients with 1-4 brain metastases receiving SRS never require salvage WBRT or SRS, and the remainder do not require salvage treatment for a median of 6 months.

Indexed as

RadiosurgeryAdolescentAdultAgedAged, 80 and overAge FactorsBrain NeoplasmsCranial IrradiationFemaleFollow-Up StudiesHumansKarnofsky Performance StatusMagnetic Resonance ImagingMaleMiddle AgedNeoplasms, Second PrimaryBrain metastasesCause of deathSalvageStereotactic radiosurgeryWhole brain radiotherapy

Identifiers

PMID26108659
OpenAlexW2154749811

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.