Evidence map›Paper›PMID 27377261›Full record

Trial reportStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2016

Radiosurgery with flattening-filter-free techniques in the treatment of brain metastases : Plan comparison and early clinical evaluation.

J Rieber, E Tonndorf-Martini, O Schramm, B Rhein, S Stefanowicz, J Kappes, H Hoffmann, K Lindel, J Debus, S Rieken

Abstract readClinical TrialComparative Study
PubMed Publisher
In one paragraph

Trial report in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 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

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

10 authors.

J RieberDepartment of Radiation Oncology, University Hospital Heidelberg, INF 400, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
E Tonndorf-MartiniDepartment of Radiation Oncology, University Hospital Heidelberg, INF 400, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
O SchrammDepartment of Radiation Oncology, University Hospital Heidelberg, INF 400, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
B RheinDepartment of Radiation Oncology, University Hospital Heidelberg, INF 400, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
S StefanowiczDepartment of Radiation Oncology, University Hospital Heidelberg, INF 400, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
J KappesTranslational Research Unit, Thoraxklinik, Heidelberg University, Heidelberg, Germany.
H HoffmannTranslational Research Unit, Thoraxklinik, Heidelberg University, Heidelberg, Germany.
K LindelDepartment of Radiation Oncology, University Hospital Heidelberg, INF 400, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
J DebusDepartment of Radiation Oncology, University Hospital Heidelberg, INF 400, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
S RiekenDepartment of Radiation Oncology, University Hospital Heidelberg, INF 400, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. stefan.rieken@med.uni-heidelberg.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRadiosurgical treatment of brain metastases is well established in daily clinical routine. Utilization of flattening-filter-free beams (FFF) may allow for more rapid delivery of treatment doses and improve clinical comfort. Hence, we compared plan quality and efficiency of radiosurgery in FFF mode to FF techniques. MATERIALS AND

methodsBetween November 2014 and June 2015, 21 consecutive patients with 25 brain metastases were treated with stereotactic radiosurgery (SRS) in FFF mode. Brain metastases received dose-fractionation schedules of 1 × 20 Gy or 1 × 18 Gy, delivered to the conformally enclosing 80 % isodose. Three patients with critically localized or large (>3 cm) brain metastases were treated with 6 × 5 Gy. Plan quality and efficiency were evaluated by analyzing conformity, dose gradients, dose to healthy brain tissue, treatment delivery time, and number of monitor units. FFF plans were compared to those using the FF method, and early clinical outcome and toxicity were assessed.

resultsFFF mode resulted in significant reductions in beam-on time (p < 0.001) and mean brain dose (p = 0.001) relative to FF-mode comparison plans. Furthermore, significant improvements in dose gradients and sharper dose falloffs were found for SRS in FFF mode (-1.1 %, -29.6 %; p ≤ 0.003), but conformity was slightly superior in SRS in FF mode (-1.3 %; p = 0.001). With a median follow-up time of 5.1 months, 6‑month overall survival was 63.3 %. Local control was observed in 24 of 25 brain metastases (96 %).

conclusionSRS in FFF mode is time efficient and provides similar plan quality with the opportunity of slightly reduced dose exposure to healthy brain tissue when compared to SRS in FF mode. Clinical outcomes appear promising and show only modest treatment-related toxicity.

Indexed as

AgedAged, 80 and overBrain InjuriesBrain NeoplasmsFemaleHumansMaleMiddle AgedPilot ProjectsRadiation InjuriesRadiosurgeryRadiotherapy, Computer-AssistedRadiotherapy DosageRadiotherapy Planning, Computer-AssistedReproducibility of ResultsSensitivity and SpecificityBrain metastasesFlattening-filter freePlan comparisonRadiosurgeryStereotactic radiotherapy

Identifiers

PMID27377261

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.