Evidence map›Paper›PMID 28438175›Full record

ArticleRadiation oncology (London, England)2017

A matched-pair analysis comparing whole-brain radiotherapy with and without a stereotactic boost for intracerebral control and overall survival in patients with one to three cerebral metastases.

Dirk Rades, Stefan Janssen, Amira Bajrovic, Mai Trong Khoa, Theo Veninga, Steven E Schild

Open access · goldAbstract read
In one paragraph

Article in Radiation oncology (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 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

6 authors at 6 institutions in 4 countries.

Dirk RadesDepartment of Radiation Oncology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. rades.dirk@gmx.net.
Stefan JanssenDepartment of Radiation Oncology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Amira BajrovicDepartment of Radiation Oncology, University Medical Center Eppendorf, Hamburg, Germany.
Mai Trong KhoaNuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam.
Theo VeningaDepartment of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg, Netherlands.
Steven E SchildDepartment of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, USA.
Bạch Mai Hospital · VNInstituut Verbeeten · NLMayo Clinic in Arizona · USMedizinische Hochschule Hannover · DEUniversität Hamburg · DEUniversity of Lübeck · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTwelve years ago, a randomized trial demonstrated that a radiosurgery boost added to whole-brain radiotherapy (WBRT) improved intracerebral control (IC) in patients with one to three cerebral metastases. Overall survival (OS) was improved only in the subgroup of patients with a single metastasis but not in the entire cohort. The present study compared both regimens in a different scenario outside a randomized trial.

methodsA total of 252 patients with one to three cerebral metastases were included. Eighty-four patients receiving WBRT plus a planned stereotactic boost and 168 patients receiving WBRT alone were individually matched 1:2 for nine factors including fractionation of WBRT, age, gender, performance score, primary tumor, number of cerebral metastases, extracerebral metastases, recursive partitioning analysis class, and time between cancer diagnosis and WBRT. Each group of three patients was required to match for all nine factors. Both groups were compared for IC and OS.

resultsIC rates at 6, 12, 18 and 24 months were 88, 71, 45 and 22% after WBRT plus stereotactic boost vs. 75, 48, 38 and 22% after WBRT alone (p = 0.005). OS rates at 6, 12, 18 and 24 months were 76, 53, 32 and 25% after WBRT plus stereotactic boost and 67, 45, 29 and 20% after WBRT alone (p = 0.10). In patients with a single lesion, OS rates were also not significantly different (p = 0.12).

conclusionsSimilar to the previous randomized trial from 2004, this matched-pair study showed that a stereotactic boost in addition to WBRT significantly improved IC but not OS.

Indexed as

Brain NeoplasmsCohort StudiesCranial IrradiationFemaleHumansMaleMatched-Pair AnalysisMiddle AgedPrognosisRadiotherapy DosageSurvival RateCerebral metastasesIntracerebral controlOverall survivalStereotactic boostWhole-brain radiotherapy

Identifiers

PMID28438175
PMCPMC5402642
OpenAlexW2609432336

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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.