Evidence map›Paper›PMID 32001383›Full record

SynthesisInternational journal of radiation oncology, biology, physics2020

Stereotactic Body Radiation Therapy of Adrenal Metastases: A Pooled Meta-Analysis and Systematic Review of 39 Studies with 1006 Patients.

William C Chen, Joe D Baal, Ulysis Baal, Jonathan Pai, Alexander Gottschalk, Lauren Boreta, Steve E Braunstein, David R Raleigh

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of radiation oncology, biology, physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing 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.

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

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

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Review
  13. Review
  14. Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
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.

William C ChenDepartment of Radiation Oncology, University of California San Francisco, California. Electronic address: William.Chen@ucsf.edu.
Joe D BaalDepartment of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
Ulysis BaalDepartment of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
Jonathan PaiDepartment of Internal Medicine, University of Southern California, Los Angeles, California.
Alexander GottschalkDepartment of Radiation Oncology, University of California San Francisco, California.
Lauren BoretaDepartment of Radiation Oncology, University of California San Francisco, California.
Steve E BraunsteinDepartment of Radiation Oncology, University of California San Francisco, California.
David R RaleighDepartment of Radiation Oncology, University of California San Francisco, California; Department of Neurological Surgery, University of California San Francisco, San Francisco, California. Electronic address: david.raleigh@ucsf.edu.

Funding

Understanding How Ciliary Hedgehog Signaling Causes MedulloblastomaK08CA212279 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI RALEIGH, DAVID R · 2017 to 2021
$886k
NCI NIH HHS K08 CA212279
6 · The paper itself

Abstract

purposeTo perform a systematic review and pooled meta-analysis of adrenal metastasis stereotactic body radiation therapy (SBRT) outcomes, treatment characteristics, and toxicity to define the efficacy and propose guidelines for intervention. METHODS AND MATERIALS: We performed a comprehensive literature search of the Embase and PubMed databases of studies reporting outcome or toxicity data for photon-based SBRT of adrenal metastases in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We then conducted a meta-analysis to estimate pooled overall response, local control (LC), and overall survival and analyzed these outcomes in the context of dosimetric parameters and toxicity using metaregression.

resultsThirty-nine studies published between 2009 and 2019 reporting outcomes on 1006 patients were included. The median follow-up was 12 months, and the median biological equivalent dose (BED10, alpha/beta = 10) was 67 Gy. The pooled overall response was 54.6% (95% confidence interval [CI], 46.5%-62.5%). The pooled 1- and 2-year rates of LC were 82% (95% CI, 74%-88%) and 63% (95% CI, 50%-74%), respectively, and the pooled 1- and 2-year overall survival rates were 66% (95% CI, 57%-74%) and 42% (95% CI, 31%-53%), respectively. There was a strong positive association between SBRT dose and 1- and 2-year LC (P < .0001, P = .0002) and an association with 2-year OS (P = .03). Based on a metaregression of dose and LC, BED10 of 60 Gy, 80 Gy, and 100 Gy predicted 1-year LC of 70.5%, 84.8%, and 92.9% and 2-year LC of 47.8%, 70.1%, and 85.6%, respectively. The overall rate of grade 3 or higher toxicity was 1.8%.

conclusionsSBRT of adrenal metastases provides good 1-year LC with an excellent safety profile, and dose escalation may be associated with improved LC. Prospective studies are needed to validate these findings and determine whether there are subsets of patients for whom adrenal metastasis-directed SBRT may confer a survival advantage.

Indexed as

RadiosurgeryAdrenal Gland NeoplasmsHumansPatient Reported Outcome MeasuresSafety

Identifiers

PMID32001383
PMCPMC8177042

What OpenQuestion holds

Textmetadata
LicenceTDM
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.