Evidence map›Paper›PMID 34594572›Full record

ArticleNeuro-oncology practice2021

Redo craniotomy or bevacizumab for symptomatic steroid-refractory true or pseudoprogression following IMRT for glioblastoma.

Theresa A Cook, Dasantha T Jayamanne, Helen R Wheeler, Matthew H F Wong, Jonathon F Parkinson, Raymond J Cook, Marina A Kastelan, Nicola J Cove, Christopher Brown, Michael F Back

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuro-oncology practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 38% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. DEGRO practical guideline for central nervous system radiation necrosis part 2: treatment.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2022
    Guideline
  2. Review
  3. Review
  4. Utility of dynamicNeuro-oncology advances
    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 3 institutions in 1 country.

Theresa A CookCentral Coast Cancer Centre, Gosford Hospital, Gosford, New South Wales, Australia.
Dasantha T JayamanneNorthern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Helen R WheelerNorthern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Matthew H F WongCentral Coast Cancer Centre, Gosford Hospital, Gosford, New South Wales, Australia.
Jonathon F ParkinsonSydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Raymond J CookDepartment of Neurosurgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Marina A KastelanNorthern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Nicola J CoveCentral Coast Cancer Centre, Gosford Hospital, Gosford, New South Wales, Australia.
Christopher BrownNorthern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Michael F BackCentral Coast Cancer Centre, Gosford Hospital, Gosford, New South Wales, Australia.
Royal North Shore Hospital · AUGosford Hospital · AUUniversity of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is minimal evidence to support decision making for symptomatic steroid-refractory pseudoprogression or true progression occurring after intensity-modulated radiation therapy (IMRT) for glioblastoma (GBM). This study audited the survival outcome of patients managed with redo craniotomy (RedoSx) or bevacizumab (BEV) for steroid-refractory mass effect after IMRT for GBM.

methodsPatients with GBM managed between 2008 and 2019 with the EORTC-NCIC Protocol were entered into a prospective database. Patients with symptomatic steroid-refractory mass effect within 6 months of IMRT managed with either RedoSx or BEV were identified for analysis. For the primary endpoint of median overall survival (OS) postintervention, outcome was analyzed in regards to potential prognostic factors, and differences between groups were assessed by log-rank analyses.

resultsOf the 399 patients managed with the EORTC-NCIC Protocol, 78 required an intervention within 6 months of IMRT completion for either true or pseudoprogression (49 with RedoSx and 29 with BEV). Subsequently, 20 of the 43 patients managed with RedoSx when BEV was clinically available, required salvage with BEV within 6 months after RedoSx. Median OS postintervention was 8.7 months (95% CI: 7.84-11.61) for the total group; and 8.7 months (95% CI: 6.8-13.1) for RedoSx and 9.4 months (95% CI: 7.8-13.6) for BEV (

conclusionsAt time of symptomatic steroid-refractory true or pseudoprogression following IMRT for GBM, BEV was equivalent to RedoSx in terms of OS. Pseudoprogression with residual cells at RedoSx was not associated with worse outcome compared to pure necrosis.

Indexed as

bevacizumabglioblastomapseudoprogressionredo craniotomy

Identifiers

PMID34594572
PMCPMC8475225
OpenAlexW3169115244

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.