Evidence map›Paper›PMID 28961826›Full record

Trial reportAnnals of oncology : official journal of the European Society for Medical Oncology2017

Whole brain radiotherapy after stereotactic radiosurgery or surgical resection among patients with one to three brain metastases and favorable prognoses: a secondary analysis of EORTC 22952-26001.

T M Churilla, E Handorf, S Collette, L Collette, Y Dong, A A Aizer, M Kocher, R Soffietti, B M Alexander, S E Weiss

Registry-linked trialAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of oncology : official journal of the European Society for Medical Oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00002899 (Phase III Trial on Convergent Beam Irradiation of Cerebral Metastases), which is not on this map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing 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.

NCT00002899 phase3terminatednot on this map

Phase III Trial on Convergent Beam Irradiation of Cerebral Metastases

TypeinterventionalSponsorEuropean Organisation for Research and Treatment of Cancer - EORTCRan1996Enrolled340ConditionsMetastatic CancerArmsadjuvant therapy, radiation therapy, stereotactic radiosurgery
3 · Its place in the literature

Who cites it

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

  1. Pooled it
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  13. Brain metastases from non-small cell lung carcinoma: an overview of classical and novel treatment strategies.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2022
    Review
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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.

T M ChurillaDepartment of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, USA.
E HandorfDepartment of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, USA.
S ColletteEORTC Headquarters, Brussels, Belgium.
L ColletteEORTC Headquarters, Brussels, Belgium.
Y DongDepartment of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, USA.
A A AizerDana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, USA.
M KocherDepartment of Radiation Oncology, University of Cologne, Cologne, Germany.
R SoffiettiDepartment of Neuro-oncology, University of Turin and City of Health and Science Hospital, Torino, Italy.
B M AlexanderDana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, USA.
S E WeissDepartment of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, USA;. Electronic address: stephanie.weiss@fccc.edu.

Funding

WORD PROCESSING CENTER--COREP30CA006927 · NCI · RESEARCH INST OF FOX CHASE CAN CTR · PI Margaret von Mehren · 1985 to 2026
$138.8M
NCI NIH HHS P30 CA006927
6 · The paper itself

Abstract

backgroundThe absence of a survival benefit for whole brain radiotherapy (WBRT) among randomized trials has been attributed to a competing risk of death from extracranial disease. We re-analyzed EORTC 22952 to assess the impact of WBRT on survival for patients with controlled extracranial disease or favorable prognoses. PATIENTS AND

methodsWe utilized Cox regression, landmark analysis, and the Kaplan-Meier method to evaluate the impact of WBRT on survival accounting for (i) extracranial progression as a time-dependent covariate in all patients and (ii) diagnosis-specific graded prognostic assessment (GPA) score in patients with primary non-small-cell lung cancer (NSCLC).

resultsA total of 329 patients treated per-protocol were included for analysis with a median follow up of 26 months. One hundred and fifteen (35%) patients had no extracranial progression; 70 (21%) patients had progression <90 days, 65 (20%) between 90 and 180 days, and 79 (24%) patients >180 days from randomization. There was no difference in the model-based risk of death in the WBRT group before [hazard ratio (HR) (95% CI)=0.70 (0.45-1.11), P = 0.133), or after [HR (95% CI)=1.20 (0.89-1.61), P = 0.214] extracranial progression. Among 177 patients with NSCLC, 175 had data available for GPA calculation. There was no significant survival benefit to WBRT among NSCLC patients with favorable GPA scores [HR (95% CI)=1.10 (0.68-1.79)] or unfavorable GPA scores [HR (95% CI)=1.11 (0.71-1.76)].

conclusionsAmong patients with limited extracranial disease and one to three brain metastases at enrollment, we found no significant survival benefit to WBRT among NSCLC patients with favorable GPA scores or patients with any histology and controlled extracranial disease status. This exploratory analysis of phase III data supports the practice of omitting WBRT for patients with limited brain metastases undergoing SRS and close surveillance. CLINICAL TRIALS NUMBER: NCT00002899.

Indexed as

Brain NeoplasmsCarcinoma, Non-Small-Cell LungFemaleHumansKaplan-Meier EstimateLung NeoplasmsMaleMiddle AgedPrognosisRadiosurgeryWhole-Body Irradiationbrain metastasesSRSstereotactic radiosurgeryWBRTwhole brain radiotherapy

Identifiers

PMID28961826
PMCPMC5834047

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.