Evidence map›Paper›PMID 27025858›Full record

ArticleJournal of neuro-oncology2016

Pattern of relapse of glioblastoma multiforme treated with radical radio-chemotherapy: Could a margin reduction be proposed?

Michela Buglione, Sara Pedretti, Pietro Luigi Poliani, Roberto Liserre, Stefano Gipponi, Giannantonio Spena, Paolo Borghetti, Ludovica Pegurri, Federica Saiani, Luigi Spiazzi and 4 more

Abstract read
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In one paragraph

Article in Journal of neuro-oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

20 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  13. New Immunotherapeutic Approaches for Glioblastoma.Journal of immunology research · 2021
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Michela BuglioneRadiation Oncology Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy. michela.buglione@unibs.it.
Sara PedrettiRadiation Oncology Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Pietro Luigi PolianiPathology Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Roberto LiserreNeuroradiology Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Stefano GipponiNeurology Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Giannantonio SpenaNeurosurgery Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Paolo BorghettiRadiation Oncology Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Ludovica PegurriRadiation Oncology Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Federica SaianiMedical Physics Department, Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Luigi SpiazziMedical Physics Department, Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Giulia TesiniMedical Physics Department, Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Chiara UccelliMedical Physics Department, Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Luca TriggianiRadiation Oncology Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.
Stefano Maria MagriniRadiation Oncology Department, University and Spedali Civili, P.le Spedali Civili 1, Brescia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To analyse the pattern of recurrence of patients treated with Stupp protocol in relation to technique, to compare in silico plans with reduced margin (1 cm) with the original ones and to analyse toxicity. 105 patients were treated: 85 had local recurrence and 68 of them were analysed. Recurrence was considered in field, marginal and distant if >80 %, 20-80 % or <20 % of the relapse volume was included in the 95 %-isodose. In silico plans were retrospectively recalculated using the same technique, fields angles and treatment planning system of the original ones. The pattern of recurrence was in field, marginal and distant in 88, 10 and 2 % respectively and was similar in in silico plans. The margin reduction appears to spare 100 cc of healthy brain by 57 Gy-volume (p = 0.02). The target coverage was worse in standard plans (pt student < 0.001), especially if the tumour was near to organs at risk (pχ2 < 0.001). PTV coverage was better with IMRT and helical-IMRT, than conformal-3D (pAnova test = 0.038). This difference was no more significant with in silico planning. A higher incidence of asthenia and leuko-encephalopathy was observed in patients with greater percentage of healthy brain included in 57 Gy-volume. No differences in the pattern of recurrence according to margins were found. The margin reduction determines sparing of healthy brain and could possibly reduce the incidence of late toxicity. Margin reduction could allow to use less sophisticated techniques, ensuring appropriate target coverage, and the choice of more costly techniques could be reserved to selected cases.

Indexed as

ChemoradiotherapyRadiotherapy, ConformalAgedBrain NeoplasmsFemaleGlioblastomaHumansIncidenceMaleMiddle AgedNeoplasm Recurrence, LocalOrgans at RiskRecurrenceRetrospective StudiesTreatment OutcomeTumor BurdenGlioblastomaMargin reductionRadio-induced late toxicityRadiotherapy techniques

Identifiers

PMID27025858

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.