Evidence map›Paper›PMID 34097171›Full record

ReviewCurrent treatment options in oncology2021

Radiation Necrosis from Stereotactic Radiosurgery-How Do We Mitigate?

Balamurugan A Vellayappan, Tresa McGranahan, Jerome Graber, Lynne Taylor, Vyshak Venur, Richard Ellenbogen, Andrew E Sloan, Kristin J Redmond, Matthew Foote, Samuel T Chao and 4 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Current treatment options in oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
3.5field-weighted citation impact, top 6% 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

19 citing papers in PubMed, 33 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Volume staging for arteriovenous malformation SRS treatment using VMAT.Journal of applied clinical medical physics · 2022
    Article
  15. Review
  16. Emerging Studies of Melanoma Brain Metastasis.Current oncology reports · 2022
    Review
  17. Article
  18. Review
  19. Review
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

14 authors at 8 institutions in 4 countries.

Balamurugan A VellayappanDepartment of Radiation oncology, National University Cancer Institute, 1E Kent Ridge Road, Level 7 Tower block, Singapore, 119228, Singapore. Bala_vellayappan@nuhs.edu.sg.ORCID 0000-0002-1077-1840
Tresa McGranahanDepartment of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA.
Jerome GraberDepartment of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA.
Lynne TaylorDepartment of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA.
Vyshak VenurDepartment of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA.
Richard EllenbogenDepartment of Neurology, Alvord Brain Tumor Center, University of Washington, Seattle, WA, USA.
Andrew E SloanDepartment of Neurological Surgery, Seidman Cancer Center and University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA.
Kristin J RedmondDepartment of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University, Baltimore, MD, USA.
Matthew FooteDepartment of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Samuel T ChaoDepartment of Radiation Oncology, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
John H SuhDepartment of Radiation Oncology, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
Eric L ChangDepartment of Radiation Oncology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
Arjun SahgalDepartment of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Simon S LoDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA.
University of Washington · USCleveland Clinic · USJohns Hopkins University · USNational University Cancer Institute, Singapore · SGPrincess Alexandra Hospital · AUSunnybrook Health Science Centre · CAUniversity Hospitals of Cleveland · USUniversity of Southern California · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

opinion statementIntracranial stereotactic radiosurgery (SRS) is an effective and convenient treatment for many brain conditions. Data regarding safety come mostly from retrospective single institutional studies and a small number of prospective studies. Variations in target delineation, treatment delivery, imaging follow-up protocols and dose prescription limit the interpretation of this data. There has been much clinical focus on radiation necrosis (RN) in particular, as it is being increasingly recognized on follow-up imaging. Symptomatic RN may be treated with medical therapy (such as corticosteroids and bevacizumab) with surgical resection being reserved for refractory patients. Nevertheless, RN remains a challenging condition to manage, and therefore upfront patient selection for SRS remains critical to provide complication-free control. Mitigation strategies need to be considered in situations where the baseline risk of RN is expected to be high-such as large target volume or re-irradiation. These may involve reduction in the prescribed dose or hypofractionated stereotactic radiation therapy (HSRT). Recently published guidelines and international meta-analysis report the benefit of HSRT in larger lesions, without compromising control rates. However, careful attention to planning parameters and SRS techniques still need to be adhered, even with HSRT. In cases where the risk is deemed to be high despite mitigation, a combination approach of surgery with or without post-operative radiation should be considered.

Indexed as

Brain NeoplasmsHumansNecrosisRadiation InjuriesRadiosurgeryTumor BurdenBrain metastasesHypofractionated stereotactic radiotherapyMitigation strategiesRadiation necrosisStereotactic radiosurgery

Identifiers

PMID34097171
OpenAlexW3172328329

What OpenQuestion holds

Textmetadata
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.