Evidence map›Paper›PMID 31338786›Full record

Observational studyJournal of neuro-oncology2019

Stereotactic radiosurgery in elderly patients with brain metastases: comparison with non-elderly patients using database of a multi-institutional prospective observational study (JLGK0901-Elderly).

Yoshinori Higuchi, Masaaki Yamamoto, Toru Serizawa, Yasunori Sato, Takashi Shuto, Atsuya Akabane, Hidefumi Jokura, Shoji Yomo, Osamu Nagano, Jun Kawagishi and 2 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study 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 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing 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

11 citing papers in PubMed.

  1. Article
  2. Review
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  6. 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

12 authors.

Yoshinori HiguchiDepartment of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Masaaki YamamotoKatsuta Hospital Mito GammaHouse, Nakane 5125-2, Hitachinaka, Ibaraki, 312-0011, Japan. bcd06275@nifty.com.ORCID http://orcid.org/0000-0002-8309-8669
Toru SerizawaTokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo, Japan.
Yasunori SatoDepartment of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.
Takashi ShutoDepartment of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Japan.
Atsuya AkabaneGamma Knife Center, NTT Medical Center Tokyo, Tokyo, Japan.
Hidefumi JokuraJiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki, Japan.
Shoji YomoDivision of Radiation Oncology, Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Japan.
Osamu NaganoGamma Knife House, Chiba Cerebral and Cardiovascular Center, Ichihara, Japan.
Jun KawagishiJiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki, Japan.
Kazuhiro YamanakaDepartment of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Hidefumi AoyamaDepartment of Radiology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan.

Funding

The Japan Brain Foundation (Japan) Not available
6 · The paper itself

Abstract

purposeStereotactic radiosurgery (SRS) has been increasingly used for elderly patients with brain metastases (BMs). However, no studies based on a large sample size have been reported. To compare SRS treatment results between elderly and non-elderly patients, we performed a subset study of elderly patients using our prospectively-accumulated multi-institution study database (JLGK0901 Study, Lancet Oncol 15:387-395, 2014).

methodsDuring the 2009-2011 period, 1194 eligible patients undergoing gamma knife SRS alone for newly diagnosed BMs were enrolled in this study from 23 gamma knife facilities in Japan. Observation was discontinued at the end of 2013. The 1194 patients were divided into the two age groups, 693 elderly ( ≥ 65 years) and 501 non-elderly ( < 65 years) patients. Our study protocol neither set an upper age limit nor required dose de-escalation.

resultsMedian post-SRS survival time was significantly shorter in the elderly than in the non-elderly patient group (10.3 vs 14.3 months, HR 1.380, 95% CI 1.218-1.563, p < 0.0001). However, regarding all secondary endpoints including neurological death, neurological deterioration, SRS-related complications, leukoencephalopathy, local recurrence, newly-developed tumors, meningeal dissemination, salvage SRS, whole brain radiotherapy and surgery and decreased mini-mental state examination scores, the elderly patient group was not inferior to the non-elderly patient group. In the 693 elderly patients, there was no post-SRS median survival time difference between those with 5-10 versus 2-4 tumors (10.8 vs 8.9 months, HR 0.936, 95% CI 0.744-1.167, p = 0.5601).

conclusionsWe conclude that elderly BM patients are not unfavorable candidates for SRS alone treatment.

Indexed as

AdultAgedAged, 80 and overAge FactorsBrain NeoplasmsDatabases, FactualFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasmsPrognosisProspective StudiesRadiosurgerySurvival RateBrain metastasesElderlyGamma knifeRadiosurgery

Identifiers

PMID31338786

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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.