Evidence map›Paper›PMID 37217924›Full record

ArticleRadiation oncology (London, England)2023

Fractionated stereotactic radiotherapy of brain metastases: results of a retrospective study.

Isabella Gruber, Philipp Stark, Karin Weidner, Marius Treutwein, Oliver Koelbl

Open access · goldAbstract read
In one paragraph

Article in Radiation oncology (London, England), 2023. 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
1.6field-weighted citation impact, top 16% 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, 6 citations in OpenAlex.

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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

5 authors at 2 institutions in 1 country.

Isabella GruberDepartment of Radiation Oncology, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, Regensburg, Bavarian, Germany. Isabella.Gruber@klinik.uni-regensburg.de.ORCID http://orcid.org/0000-0002-7435-9337
Philipp StarkUniversity of Regensburg, Universitätsstraße 31, Regensburg, Bavarian, Germany.
Karin WeidnerDepartment of Radiation Oncology, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, Regensburg, Bavarian, Germany.ORCID http://orcid.org/0000-0002-6538-9980
Marius TreutweinDepartment of Radiation Oncology, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, Regensburg, Bavarian, Germany.
Oliver KoelblDepartment of Radiation Oncology, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, Regensburg, Bavarian, Germany.
University Hospital Regensburg · DEOTH Regensburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLasting local control of brain metastases following stereotactic radiotherapy is becoming increasingly relevant since systemic treatment constantly improves the prognosis of patients with extracranial metastases.

methods73 patients with 103 brain metastases received hypofractionated stereotactic radiotherapy (FSRT) in 6 fractions of 5 Gy between January 2017 and December 2021 at the University Hospital Regensburg, Germany. The study retrospectively evaluated local progression free survival (LPFS), overall survival (OS) and distant brain progression free survival (DPFS) of patients without prior radiotherapy of the brain. Response rate and brain radiation necrosis were reported. Cox proportional hazard models evaluated prognostic factors of OS and LPFS.

resultsThe median patient age was 61.0 years (Interquartile range, IQR 51.0, 67.5). The most common tumor types were malignant melanoma (34.2%) and non-small cell lung adenocarcinoma (26.0%). The median gross tumor volume (GTV) was 0.9 cm³ (IQR 0.4, 3.6). The median follow-up time of all patients was 36.3 months (95%CI 29.1, 43.4). The median OS was 17.4 months (95%CI 9.9, 24.9). Overall survival rates at 6-, 12-, 18-, 24-, and 30 months were 81.9%, 59.1%, 49.0%, 41.3%, and 37.2%, retrospectively. The mean LPFS was 38.1 months (95%CI 31.4, 44.9), while the median LPFS has not been reached. LPFS rates at 6-, 12-, 18-, 24- and 30 months were 78.9%, 68.7%, 64.3%, 61.6% and 58.7%, retrospectively. Median DPFS of all patients was 7.7 months (95%CI 6.1, 9.3). Six, 12-, 18-, 24- and 30 months DPFS rates were 62.1%, 36.3%, 31.1%, 24.8% and 21.7%. Five brain metastases (4.8%) developed brain radiation necrosis. In multivariate analysis, the number of brain metastases negatively affected LPFS. Non-melanoma and non-renal cell cancer was associated with a higher chance of LPFS in comparison to other cancer. A GTV > 1.5 cm³ translated into a higher risk of death compared to a GTV ≤ 1.5 cm³ and Karnofsky performance score was predictive of OS.

conclusionsFSRT in 6 fractions of 5 Gy seems to be an effective treatment with an acceptable local control for patients with brain metastases although melanoma and renal cell cancer seem to have a worse local control in comparison to other cancer.

trial registrationThis study is retrospectively registered.

Indexed as

Brain NeoplasmsCarcinoma, Renal CellKidney NeoplasmsRadiosurgeryHumansMiddle AgedNecrosisRetrospective StudiesTreatment OutcomeBrain metastasesBrain radiation necrosisFractionated stereotactic radiotherapyMalignant melanomaRenal cell cancer

Identifiers

PMID37217924
PMCPMC10201793
OpenAlexW4377289662

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.