Evidence map›Paper›PMID 30523605›Full record

SynthesisJournal of neuro-oncology2019

Re-irradiation for recurrent glioblastoma (GBM): a systematic review and meta-analysis.

Farasat Kazmi, Yu Yang Soon, Yiat Horng Leong, Wee Yao Koh, Balamurugan Vellayappan

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 7 pooled it
7.4field-weighted citation impact, top 2% 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

97 citing papers in PubMed, 7 syntheses or guidelines pooled it, 149 citations in OpenAlex.

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37 more citing papers are in PubMed but not listed here.

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

5 authors at 2 institutions in 1 country.

Farasat KazmiDepartment of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital, Singapore, 119228, Singapore.
Yu Yang SoonDepartment of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital, Singapore, 119228, Singapore.
Yiat Horng LeongDepartment of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital, Singapore, 119228, Singapore.
Wee Yao KohDepartment of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital, Singapore, 119228, Singapore.
Balamurugan VellayappanDepartment of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital, Singapore, 119228, Singapore. bala_vellayappan@nuhs.edu.sg.ORCID http://orcid.org/0000-0002-1077-1840
National University Cancer Institute, Singapore · SGNational University of Singapore · SG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine the efficacy and toxicity of re-irradiation for patients with recurrent GBM. MATERIALS AND

methodsWe searched various biomedical databases from 1998 to 2018, for eligible studies where patients were treated with re-irradiation for recurrent GBM. Outcomes of interest were 6 and 12-month overall survival (OS-6, OS-12), 6 and 12-month progression free survival (PFS-6, PFS-12) and serious (Grade 3 +) adverse events (AE). We used the random effects model to pool outcomes across studies and compared pre-defined subgroups using interaction test. Methodological quality of each study was assessed using the Newcastle-Ottawa scoring system.

resultsWe found 50 eligible non-comparative studies including 2095 patients. Of these, 42% were of good or fair quality. The pooled results were as follows: OS-6 rate 73% (95% confidence interval (CI) 69-77%), OS-12 rate 36% (95% CI 32-40%), PFS-6 rate 43% (95% CI 35-50%), PFS-12 rate 17% (95% CI 13-20%), and Grade 3 + AE rate 7% (95% CI 4-10%). Subgroup analysis showed that prospective studies reported higher toxicity rates, and studies which utilized brachytherapy to have a longer OS-12. Within the external beam radiotherapy group, there was no dose-response [above or below 36 Gy in 2 Gy equivalent doses (EQD2)]. However, a short fractionation regimen (≤ 5 fractions) seemed to provide superior PFS-6.

conclusionThe available evidence, albeit mostly level III, suggests that re-irradiation provides encouraging disease control and survival rates. Toxicity was not uniformly reported, but seemed to be low from the included studies. Randomized controlled trials (RCT) are needed to establish the optimal management strategy for recurrent GBM.

Indexed as

Brain NeoplasmsGlioblastomaHumansNeoplasm Recurrence, LocalRe-IrradiationSurvival RateTreatment OutcomeBrachytherapyGlioblastoma multiformeRecurrenceRe-irradiationStereotactic radiosurgery

Identifiers

PMID30523605
OpenAlexW2904710333

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.