Evidence map›Paper›PMID 34100178›Full record

ArticleJournal of neuro-oncology2021

Peri-radiosurgical administration of bevacizumab improves radiographic response to single and fractionated stereotactic radiosurgery for large brain metastasis.

Yi-Lun Chen, Abel Po-Hao Huang, Chia-Chun Wang, Hung-Yi Chen, Ya-Fang Chen, Furen Xiao, Shao-Lun Lu, Jason Chia-Hsien Cheng, Feng-Ming Hsu

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In one paragraph

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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 41% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. 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

9 authors at 2 institutions in 1 country.

Yi-Lun ChenDivision of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd., Taipei, 10002, Taiwan.
Abel Po-Hao HuangDivision of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Chia-Chun WangDivision of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd., Taipei, 10002, Taiwan.
Hung-Yi ChenDivision of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd., Taipei, 10002, Taiwan.
Ya-Fang ChenDepartment of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Furen XiaoDivision of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Shao-Lun LuDivision of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd., Taipei, 10002, Taiwan.
Jason Chia-Hsien ChengDivision of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd., Taipei, 10002, Taiwan.
Feng-Ming HsuDivision of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd., Taipei, 10002, Taiwan. hsufengming@ntuh.gov.tw.ORCID http://orcid.org/0000-0001-9943-6039
National Taiwan University Hospital · TWNational Taiwan University · TW

Funding

Ministry of Science and Technology, Taiwan 107-2314-B-002 -098
6 · The paper itself

Abstract

introductionStereotactic radiosurgery (SRS) is a standard of care for brain metastases (BM) patients, yet large BM are at a greater risk for radionecrosis and local progression (LP). Concomitant bevacizumab and radiotherapy has been shown to improve outcomes in primary and metastatic brain tumors. This retrospective study investigated the efficacy and safety of concurrent bevacizumab and SRS for large BM.

methodsFrom 2015 to 2019, patients with a BM diameter ≥ 2 cm who received either combination therapy (n = 49, SRS + BVZ group), or SRS alone (n = 73, SRS group) were enrolled. Bevacizumab was given peri-radiosurgically with a 2-week interval. Radiographic response was assessed using the RECIST version 1.1. Competing risk and logistic regression analysis were performed to evaluate prognostic factors.

resultsRadiographic response was achieved in 41 patients (84%) in the SRS + BVZ group and 37 patients (51%) in the SRS group (p = 0.001). In the multivariate regression analysis, concurrent bevacizumab was independently associated with a better radiographic response (p = 0.003). The cumulative incidences of LP and ≥ grade 2 radionecrosis at 12 months between the SRS + BVZ group and SRS group were 2% versus 6.8%, and 14.3% versus 14.6%, respectively. For patients with BM size ≥ 3 cm, the cumulative incidence of LP was significantly lower in the SRS + BVZ group (p = 0.03). No ≥ grade 4 toxicity was observed in either group.

conclusionsConcurrent bevacizumab and SRS for large BM is highly effective, with a better radiographic response and minimal excessive treatment-related toxicities. Peri-radiosurgical bevacizumab preferentially reduced the risk of LP, especially for BM size ≥ 3 cm.

Indexed as

Brain NeoplasmsRadiosurgeryBevacizumabCombined Modality TherapyHumansRadiation InjuriesRetrospective StudiesBevacizumabBevacizumabBrain metastasesRadionecrosisResponseStereotactic radiosurgery

Identifiers

PMID34100178
OpenAlexW3167840032

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.