ArticleJournal of neuro-oncology2021
Type and timing of systemic therapy use predict overall survival for patients with brain metastases treated with radiation therapy.
Article in Journal of neuro-oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The trial behind it
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Who cites it
6 citing papers in PubMed.
- RAPid simPLE (RAPPLE) Targeted Radiation Treatment Versus Whole Brain Radiation Therapy: A Retrospective Cohort Study of Matched Patients With Brain Metastases and Poor Prognosis.Advances in radiation oncology · 2026Article
- Intraoperative radiotherapy in brain metastasis surgery allows faster transition to systemic therapy.Neuro-oncology practice · 2025Article
- The Canadian Breast Cancer Symposium 2023 Meeting Report.Current oncology (Toronto, Ont.) · 2024Article
- Optimizing treatment of brain metastases in an era of novel systemic treatments: a single center consecutive series.Journal of neuro-oncology · 2023Article
- Brain metastases in Japanese NSCLC patients: prognostic assessment and the use of osimertinib and immune checkpoint inhibitors-retrospective study.Radiation oncology (London, England) · 2023Article
- Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThis study aimed to investigate whether systemic therapy (ST) use surrounding radiation therapy (RT) predicts overall survival (OS) after RT for patients with brain metastases (BMs).
methodsProvincial RT and pharmacy databases were used to review all adult patients in British Columbia, Canada, who received a first course of RT for BMs between 2012 and 2016 (n = 3095). Multivariate analysis on a randomly selected subset was used to develop an OS nomogram.
resultsIn comparison to the 2096 non-recipients of ST after RT, the median OS of the 999 recipients of ST after RT was 5.0 (95% Confidence interval (CI) 4.1-6.0) months longer (p < 0.0001). Some types of ST after RT were independently predictive of OS: targeted therapy (hazard ratio (HR) 0.42, CI 0.37-0.48), hormone therapy (HR 0.45, CI 0.36-0.55), cytotoxic chemotherapy (HR 0.71, CI 0.64-0.79), and immunotherapy (HR 0.64, CI 0.37-1.06). Patients who discontinued ST after RT had 0.9 (CI 0.3-1.4) months shorter median OS than patients who received no ST before or after RT (p < 0.0001). In the multivariate analysis of the 220-patient subset, established prognostic variables (extracranial disease, performance status, age, cancer diagnosis, and number of BMs), and the novel variables "ST before RT" and "Type of ST after RT" independently predicted OS. The nomogram predicted 6- and 12-month OS probability and median OS (bootstrap-corrected Harrell's Concordance Index = 0.70).
conclusionsThe type and timing of ST use surrounding RT predict OS for patients with BMs.
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