Evidence map›Paper›PMID 30029684›Full record

Trial reportRadiation oncology (London, England)2018

Quality assurance analysis of hippocampal avoidance in a melanoma whole brain radiotherapy randomized trial shows good compliance.

Geoffrey Martinage, Angela M Hong, Mike Fay, Thanuja Thachil, Daniel Roos, Narelle Williams, Serigne Lo, Gerald Fogarty

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Radiation oncology (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01503827 (Whole Brain Radiotherapy Following Local Treatment of Intracranial Metastases of Melanoma - A Randomised Phase III Trial), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.5field-weighted citation impact, top 30% 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.

NCT01503827 naunknown statusnot on this map

Whole Brain Radiotherapy Following Local Treatment of Intracranial Metastases of Melanoma - A Randomised Phase III Trial

TypeinterventionalSponsorMelanoma and Skin Cancer Trials LimitedRan2007 to 2022Enrolled220ConditionsMetastatic MelanomaArmsWBRT
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Article
  5. Review
  6. Review
  7. Radiotherapy for Melanoma: More than DNA Damage.Dermatology research and practice · 2019
    Review
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

8 authors at 4 institutions in 3 countries.

Geoffrey MartinageMelanoma Institute Australia, The University of Sydney, NSW, North Sydney, Australia.
Angela M HongMelanoma Institute Australia, The University of Sydney, NSW, North Sydney, Australia.
Mike FaySchool of Medicine and Public Health, University of Newcastle, NSW, Callaghan, Australia.
Thanuja ThachilNorthern Territory Radiation Oncology, Alan Walker Cancer Care Centre, NT, Darwin, Australia.
Daniel RoosRoyal Adelaide Hospital, Adelaide, South Australia, Australia.
Narelle WilliamsAustralia and New Zealand Melanoma Trials Group, NSW, North Sydney, Australia.
Serigne LoMelanoma Institute Australia, The University of Sydney, NSW, North Sydney, Australia.
Gerald FogartyMelanoma Institute Australia, The University of Sydney, NSW, North Sydney, Australia. Gerald.fogarty@cancer.com.au.
Mater Health Services · AUMelanoma Institute Australia · AUGenesis HealthCare · USRoyal Adelaide Hospital · AU

Funding

Cancer Australia 1084046
6 · The paper itself

Abstract

backgroundMelanoma brain metastases (MBM) often cause morbidity and mortality for stage IV melanoma patients. An ongoing randomised phase III trial (NCT01503827 - WBRT-Mel) evaluates the role of adjuvant whole brain radiotherapy (WBRT) following local treatment of MBM. Hippocampal avoidance during WBRT (HA-WBRT) has shown memory and neurocognitive function (NCF) preservation in the RTOG-0933 phase II study. This study assessed the quality assurance of HA-WBRT within the WBRT-Mel trial according to RTOG-0933 study criteria.

methodsHippocampal avoidance was allowed in approved centres with intensity-modulated radiotherapy capability. Patients treated by HA-WBRT were not randomized within the WBRT arm. The RTOG 0933 contouring Atlas was used to contour hippocampi. In the trial co-ordinating centre, patients were treated with volumetric modulated arc therapy using complementary arcs; similar techniques were used at other sites. Dosimetric data were extracted retrospectively and analysed in accordance with RTOG 0933 study constraints criteria.

resultsAmong the 215 patients accrued to the WBRT-Mel study between April 2009 and September 2017, 107 were randomized to the WBRT arm, 22 were treated by HA-WBRT in 4 centers. Eighteen patients were treated in the same centre. The median age was 65 years. The commonest (91%) HA-WBRT schema was 30 Gy in 10 fractions. Prior to HA-WBRT, 10 patients had been treated by surgery alone, six by radiosurgery alone, four by surgery and radiosurgery and two exclusively by simultaneous integrated boost concurrent to HA-WBRT. Twenty patients were treated with intention to spare both hippocampi and two patients had MBM close to one hippocampus and were treated with intention to spare the contralateral hippocampus. According to RTOG-0933 study criteria, 18 patients (82%) were treated within constraints and four patients (18%) had unacceptable deviation in just one hippocampus.

conclusionsThis dosimetric quality assurance study shows good compliance (82%) according to RTOG-0933 study dosimetric constraints. Indeed, all patients respected RTOG hippocampal avoidance constraints on at least one hippocampus. In the futureanalysis of the WBRT-Mel trial, the NCF of patients on the observation arm, WBRT arm and with HA-WBRT arm will be compared.

Indexed as

Quality Assurance, Health CareAdultAgedAged, 80 and overAustraliaBrain NeoplasmsCranial IrradiationDose Fractionation, RadiationFemaleHippocampusHumansMaleMelanomaMiddle AgedOrgan Sparing TreatmentsRadiation InjuriesHippocampal avoidanceIntensity-modulated radiotherapyQuality assuranceRadiotherapyTrialWhole brain radiotherapy

Identifiers

PMID30029684
PMCPMC6053726
OpenAlexW2883409344

What OpenQuestion holds

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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.