Evidence map›Paper›PMID 28740873›Full record

ArticleAdvances in radiation oncology

A phase 2 study of radiosurgery and temozolomide for patients with 1 to 4 brain metastases.

John B Fiveash, Waleed O Arafat, George E Naoum, Barton L Guthrie, Stephen M Sawrie, Sharon A Spencer, Ruby F Meredith, James M Markert, Robert M Conry, Burt L Nabors

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Article in Advances in radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Radiotherapy for Melanoma: More than DNA Damage.Dermatology research and practice · 2019
    Review
  2. Article
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.

John B FiveashDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
Waleed O ArafatDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
George E NaoumAlexandria Comprehensive Cancer Center, Alexandria, Egypt.
Barton L GuthrieDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
Stephen M SawrieDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
Sharon A SpencerDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
Ruby F MeredithDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
James M MarkertDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
Robert M ConryDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
Burt L NaborsDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine if temozolomide reduces the risk of distant brain failure (DBF, metachronous brain metastases) in patients with 1 to 4 brain metastases treated with radiosurgery without whole-brain radiation therapy (WBRT). METHODS AND MATERIALS: Twenty-five patients with newly diagnosed brain metastases were enrolled in a single institution phase 2 trial of radiosurgery (15-24 Gy) and adjuvant temozolomide. Temozolomide was continued for a total of 12 cycles unless the patient developed DBF, unacceptable toxicity, or systemic progression requiring other therapy.

resultsTwenty-five patients were enrolled between 2002 and 2005; 3 were not evaluable for determining DBF. Of the remaining 22 patients, tumor types included non-small cell lung cancer (n = 8), melanoma (n = 7), and other (n = 7). Extracranial disease was present in 10 (45%) patients. The median number of tumors at the time of radiosurgery was 3 (range, 1-6). The median overall survival was 31 weeks. The median radiographic follow-up for patients who did not develop DBF was 33 weeks. Six patients developed DBF. The 1-year actuarial risk of DBF was 37%.

conclusionsIn this study, there was a relatively low risk of distant brain failure observed in the nonmelanoma subgroup receiving temozolamide. However, patient selection factors rather than chemotherapy treatment efficacy are more likely the reason for the relatively low risk of distant brain failure observed in this study. Future trial design should account for these risk factors.

Identifiers

PMID28740873
PMCPMC5506740

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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.