Evidence map›Paper›PMID 35267049›Full record

ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2022

Whole brain radiotherapy combined with intrathecal liposomal cytarabine for leptomeningeal metastasis-a safety analysis and validation of the EANO-ESMO classification.

Sarah Iglseder, Martha Nowosielski, Gabriel Bsteh, Armin Muigg, Johanna Heugenhauser, Elke Mayer, Astrid Grams, Günther Stockhammer, Meinhard Nevinny-Stickel

Open access · hybridAbstract read
In one paragraph

Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.8field-weighted citation impact, top 14% 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, 13 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
  4. 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

9 authors at 2 institutions in 1 country.

Sarah IglsederDepartment of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Martha NowosielskiDepartment of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria. martha.nowosielski@i-med.ac.at.ORCID 0000-0002-8068-315X
Gabriel BstehDepartment of Neurology, Medical University of Vienna, Vienna, Austria.
Armin MuiggDepartment of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Johanna HeugenhauserDepartment of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Elke MayerDepartment of Therapeutic Radiology and Oncology, Medical University of Innsbruck, Innsbruck, Austria.
Astrid GramsDepartment of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria.
Günther StockhammerDepartment of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Meinhard Nevinny-StickelDepartment of Therapeutic Radiology and Oncology, Medical University of Innsbruck, Innsbruck, Austria.
Innsbruck Medical University · ATMedical University of Vienna · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough there is no proven standard therapy for leptomeningeal metastases (LM), treatment often includes intrathecal chemotherapy combined with whole brain radiation therapy (WBRT). Little is known about the toxicity of such combination therapies. We performed a retrospective safety analysis for the combination of intrathecal liposomal cytarabine with WBRT in patients with LM and validated the EANO-ESMO (European Association of Neuro-oncology-European Society for Medical Oncology) classification in this unique cohort.

methodsTreatment toxicities in patients diagnosed with LM between 2004 and 2014 were retrospectively analyzed according to RTOG (Radiation Therapy Oncology Group) toxicity criteria and NCI CTCAE V5.0 (National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0). Diagnostic criteria and treatment response as assessed by EANO-ESMO classification were correlated with survival by Kaplan-Meier analysis and Breslow test.

resultsIn all, 40 patients with LM who were treated with combined WBRT and intrathecal cytarabine, were identified. Ten patients (25%) experienced adverse events ≥grade 3 according to RTOG toxicity criteria; in 22 patients (55%) NCI CTCAE ≥grade 3 were detected. Median overall survival was 124 days. Median time to neurological progression was 52 days. Patients with positive cerebrospinal fluid (CSF) cytology (n = 26) showed worse prognosis compared to patients with negative CSF cytology (n = 14; mOS (median overall survival) 84 days versus 198 days, p = 0.006, respectively). The EANO-ESMO response assessment was significantly associated with survival: "stable" (n = 7) mOS 233 days, "response" (n = 10) mOS 206 days, "progression" (n = 17) mOS 45 days, "suspicion of progression" (n = 6) mOS 133 days; overall, p < 0.001.

conclusionsIn this retrospective analysis, combined treatment of WBRT and intrathecal liposomal cytarabine shows an acceptable safety profile and may indicate a trend towards improved efficacy. The EANO-ESMO classification for diagnosis and treatment response predicts survival.

Indexed as

Meningeal CarcinomatosisBrainCytarabineHumansImmunotherapyRetrospective StudiesCytarabineIntrathecal therapy (DepoCyte®)Leptomeningeal metastasesOutcomeSurvival analysis

Identifiers

PMID35267049
PMCPMC9038800
OpenAlexW4220988072

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.