Evidence map›Paper›PMID 30800551›Full record

ArticleCureus2018

CyberKnife Radiosurgery in Recurrent Brain Metastases: Do the Benefits Outweigh the Risks?

Alexander Romagna, Romagna Alexander, Christoph Schwartz, Barbara Ladisich, Wolfgang Hitzl, Sarah-Charlotta Heidorn, Peter A Winkler, Alexander Muacevic

Erratum issuedOpen access · diamondAbstract read
In one paragraph

Article in Cureus, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 28% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 3 countries.

Alexander Romagna
Romagna Alexander *Neurosurgery, Christian-Doppler-Medical Center, Paracelsus Private Medical University, Salzburg, AUT.
Christoph SchwartzNeurosurgery, Christian-Doppler-Medical Center, Paracelsus Private Medical University, Salzburg, AUT.
Barbara LadisichNeurosurgery, Christian-Doppler-Medical Center, Paracelsus Private Medical University, Salzburg, AUT.
Wolfgang HitzlBiostatistics, Christian-Doppler-Medical Center, Paracelsus Private Medical University, Salzburg, AUT.
Sarah-Charlotta HeidornMedical Physicist, European CyberKnife Center Munich, Munich, DEU.
Peter A WinklerNeurosurgery, Christian-Doppler-Medical Center, Paracelsus Private Medical University, Salzburg, AUT.
Alexander MuacevicRadiosurgery, European CyberKnife Center Munich, Munich, DEU.
European Patent Organisation · DEParacelsus Medical University · ATChristian Doppler Klinik · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction Local treatment concepts are in high demand in the salvage treatment of recurrent brain metastases. Still, their risks and benefits are scarcely characterized. In this study, we analyzed the outcome and risk-/benefit-ratio of salvage CyberKnife (Accuray Incorporated, Sunnyvale, California, US) radiosurgery in the treatment of recurrent brain metastases after whole brain radiotherapy (WBRT). Materials and methods Seventy-six patients with 166 recurrent brain metastases and a multimodal pretreatment were retrospectively investigated. All patients underwent salvage CyberKnife radiosurgery (single fraction, reference dose: 17-22 Gy). Study endpoints were post-recurrence survival (PRS) after salvage treatment as well as local and distant tumor control rates. Central nervous system (CNS) toxicity was assessed according to the toxicity criteria of the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer (RTOG/EORTC)). Results The population was homogenous regarding its demographic parameters. All patients had a history of WBRT prior to salvage CyberKnife radiosurgery. PRS was 13.3 months (10.4 - 16.2 months), one-year local and distant tumor control rates were 87% (95% CI: 75-99) and 38% (95% CI: 23-52), respectively. Eighteen patients suffered from RTOG/EORTC grade I/II toxicity. No toxicity-related risk factors were identified. Discussion This study found indicative survival and tumor control rates as well as a favorable risk/benefit ratio regarding radiotoxicity in salvage CyberKnife radiosurgery. These results point to a proactive therapeutic strategy based on appropriate patient selection instead of therapeutic nihilism.

Indexed as

cyberknife radiosurgerylocal treatmentrecurrent brain metastases

Identifiers

PMID30800551
PMCPMC6384047
OpenAlexW2904285860

What OpenQuestion holds

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LicenceCC BY
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.