Evidence map›Paper›PMID 32307637›Full record

ArticleJournal of neuro-oncology2020

Early experience with hippocampal avoidance whole brain radiation therapy and simultaneous integrated boost for brain metastases.

Emily S Lebow, William L Hwang, Stephen Zieminski, Yi Wang, Andrzej Niemierko, William A Mehan, Kevin S Oh, Melin Khandekar, Henning Willers, Helen A Shih

Abstract read
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In one paragraph

Article in Journal of neuro-oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
0.6field-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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Whole-brain radiotherapy with simultaneous integrated boost in treatment of patients with brain metastases: a systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
  4. Article
  5. Article
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  7. Article
  8. Article
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  10. Advances in radiotherapy for brain metastases.Neuro-oncology advances · 2021
    Article
  11. 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

10 authors at 2 institutions in 1 country.

Emily S LebowDepartment of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA.
William L HwangDepartment of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA.
Stephen ZieminskiDepartment of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA.
Yi WangDepartment of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA.
Andrzej NiemierkoDepartment of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA.
William A MehanDepartment of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Kevin S OhDepartment of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA.
Melin KhandekarDepartment of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA.
Henning WillersDepartment of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA.
Helen A ShihDepartment of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA, 02114, USA. hshih@mgh.harvard.edu.
Massachusetts General Hospital · USHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCranial irradiation results in cognitive decline, which is hypothesized to be partially attributable to hippocampal injury and stem cell loss. Recent advances allow for targeted reduction of radiation dose to the hippocampi while maintaining adequate dose coverage to the brain parenchyma and additional increasing dose to brain metastases, a approach called hippocampal avoidance whole brain radiation therapy with a simultaneous integrated boost (HA-WBRT + SIB.) We review our early clinical experience with HA-WBRT + SIB. MATERIALS AND

methodsWe evaluated treatments and clinical outcomes for patients treated with HA-WBRT + SIB between 2014 and 2018.

resultsA total of 32 patients (median age, 63.5 years, range 45.3-78.8 years) completed HA-WBRT + SIB. Median follow-up for patients alive at the time of analysis was 11.3 months. The most common histology was non-small cell lung cancer (n = 22). Most patients (n = 25) were prescribed with WBRT dose of 30 Gy with SIB to 37.5 Gy in 15 fractions. Volumetric modulated arc therapy reduced treatment time (p < 0.0001). Median freedom from intracranial progression and overall survival from completion of treatment were 11.4 months and 19.6 months, respectively. Karnofsky Performance Status was associated with improved survival (p = 0.008). The most common toxicities were alopecia, fatigue, and nausea. Five patients developed cognitive impairment, including grade 1 (n = 3), grade 2 (n = 1), and grade 3 (n = 1).

conclusionHA-WBRT + SIB demonstrated durable intracranial disease control with modest side effects and merits further investigation as a means of WBRT toxicity reduction while improving long-term locoregional control in the brain.

Indexed as

AgedBrain NeoplasmsCranial IrradiationFemaleHippocampusHumansKaplan-Meier EstimateMaleMiddle AgedRadiation InjuriesRadiotherapy Planning, Computer-AssistedTreatment OutcomeBrain metastasesCognitive toxicityHippocampal avoidanceSimultaneous integrated boostWhole brain radiation therapy

Identifiers

PMID32307637
OpenAlexW3017212409

What OpenQuestion holds

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Registered trials

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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.