Evidence map›Paper›PMID 34940951›Full record

ArticleJournal of neuro-oncology2022

Accelerated hyper-versus normofractionated radiochemotherapy with temozolomide in patients with glioblastoma: a multicenter retrospective analysis.

Rainer J Klement, Ilinca Popp, David Kaul, Felix Ehret, Anca L Grosu, Bülent Polat, Reinhart A Sweeney, Victor Lewitzki

Open access · hybridAbstract readMulticenter Study
In one paragraph

Article in Journal of neuro-oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact, top 75% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
  3. 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

8 authors at 7 institutions in 2 countries.

Rainer J KlementKlinik für Strahlentherapie, Leopoldina Krankenhaus Schweinfurt, MVZ Leopoldina Krankenhaus, Robert-Koch-Straße 10, 97422, Schweinfurt, Germany. rainer_klement@gmx.de.ORCID http://orcid.org/0000-0003-1401-4270
Ilinca PoppKlinik für Strahlenheilkunde, Universitätsklinikum Freiburg, 79106, Freiburg, Germany.
David KaulKlinik Für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany.
Felix EhretKlinik Für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany.ORCID http://orcid.org/0000-0001-6177-1755
Anca L GrosuKlinik für Strahlenheilkunde, Universitätsklinikum Freiburg, 79106, Freiburg, Germany.
Bülent PolatKlinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany.
Reinhart A SweeneyKlinik für Strahlentherapie, Leopoldina Krankenhaus Schweinfurt, MVZ Leopoldina Krankenhaus, Robert-Koch-Straße 10, 97422, Schweinfurt, Germany.
Victor LewitzkiKlinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany. lewitzki_v@ukw.de.ORCID http://orcid.org/0000-0001-9146-3083
Klinik und Poliklinik für Strahlentherapie und Radioonkologie · DEGerman Cancer Research Center · DEGerman Cancer Society · DELeopoldina Krankenhaus Schweinfurt · DEUniversitäts-Kinderklinik Würzburg · DEUniversity Medical Center Freiburg · DEUniversity of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeThe standard treatment of glioblastoma patients consists of surgery followed by normofractionated radiotherapy (NFRT) with concomitant and adjuvant temozolomide chemotherapy. Whether accelerated hyperfractionated radiotherapy (HFRT) yields comparable results to NFRT in combination with temozolomide has only sparsely been investigated. The objective of this study was to compare NFRT with HFRT in a multicenter analysis. MATERIALS AND

methodsA total of 484 glioblastoma patients from four centers were retrospectively pooled and analyzed. Three-hundred-ten and 174 patients had been treated with NFRT (30 × 1.8 Gy or 30 × 2 Gy) and HFRT (37 × 1.6 Gy or 30 × 1.8 Gy twice/day), respectively. The primary outcome of interest was overall survival (OS) which was correlated with patient-, tumor- and treatment-related variables via univariable and multivariable Cox frailty models. For multivariable modeling, missing covariates were imputed using multiple imputation by chained equations, and a sensitivity analysis was performed on the complete-cases-only dataset.

resultsAfter a median follow-up of 15.7 months (range 0.8-88.6 months), median OS was 16.9 months (15.0-18.7 months) in the NFRT group and 14.9 months (13.2-17.3 months) in the HFRT group (p = 0.26). In multivariable frailty regression, better performance status, gross-total versus not gross-total resection, MGMT hypermethylation, IDH mutation, smaller planning target volume and salvage therapy were significantly associated with longer OS (all p < 0.01). Treatment differences (HFRT versus NFRT) had no significant effect on OS in either univariable or multivariable analysis.

conclusionsSince HFRT with temozolomide was not associated with worse OS, we assume HFRT to be a potential option for patients wishing to shorten their treatment time.

Indexed as

Brain NeoplasmsChemoradiotherapyGlioblastomaTemozolomideAntineoplastic Agents, AlkylatingFollow-Up StudiesFrailtyHumansRetrospective StudiesSurvival AnalysisTreatment OutcomeAntineoplastic Agents, AlkylatingTemozolomideAccelerated hyperfractionationAltered fractionationGlioblastomaRadiotherapyTemozolomide

Identifiers

PMID34940951
PMCPMC8817053
OpenAlexW4200400471

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.