Evidence map›Paper›PMID 37656378›Full record

ArticleJournal of neuro-oncology2023

Is it advisable to perform radiosurgery for EGFR-TKI-controlled brain metastases? A retrospective study of the role of radiosurgery in lung cancer treatment.

Joseph Shang-En Hung, Yan-Hua Su, Ching-Jen Chen, Chi-Lu Chiang, Chia-I Shen, Huai-Che Yang, Cheng-Ying Shiau, Yung-Hung Luo, Hsiu-Mei Wu, Yong-Sin Hu and 5 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 36% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

15 authors at 3 institutions in 2 countries.

Joseph Shang-En HungDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Yan-Hua SuDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Ching-Jen ChenDepartment of Neurological Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Chi-Lu ChiangDepartment of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Chia-I ShenDepartment of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Huai-Che YangDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Cheng-Ying ShiauInstitute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Yung-Hung LuoDepartment of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Hsiu-Mei WuSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Yong-Sin HuSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Chung-Jung LinSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Kang-Du LiuDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Wen-Yuh ChungDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Wan-Yuo GuoSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Cheng-Chia LeeDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. yfnaughty@gmail.com.
National Yang Ming Chiao Tung University · TWTaipei Veterans General Hospital · TWNeurological Surgery · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeGiven the availability of TKIs with high central nervous system efficacy, the question arises as to whether upfront SRS provides additional clinical benefits. The goal of this study was to characterize the clinical outcomes of SRS as salvage therapy for TKI-uncontrolled BMs.

methodsThis retrospective study included EGFR-mutant NSCLC patients presenting BMs at the time of primary tumor diagnosis. BMs were categorized into three subgroups, referred to as "Nature of TKI-treated BMs", "TKI-controlled brain metastases ± SRS", and "SRS salvage therapy". The first subgroup analysis characterized the effects of TKIs on tumor behavior. In the second subgroup, we compared outcomes of TKI-controlled BMs treated with TKI alone versus those treated with combined TKI-SRS therapy. The third subgroup characterized the outcomes of TKI-uncontrolled BMs treated with SRS as salvage therapy Clinical outcomes include local and distant tumor control.

resultsThis study included 106 patients with a total of 683 BMs. TKI treatment achieved control in 63% of local tumors at 24 months. Among the TKI-controlled BMs, local tumor control was significantly higher in the combined TKI-SRS group (93%) than in the TKI-alone group (65%) at 24 months (p < 0.001). No differences were observed between the two groups in terms of distant tumor control (p = 0.832). In dealing with TKI-uncontrolled BMs, salvage SRS achieved local tumor control in 58% of BMs at 24 months.

conclusionsWhile upfront TKI alone proved highly effective in BM control, this study also demonstrated the outcomes of SRS when implemented concurrently with TKI or as salvage therapy for TKI-uncontrolled BMs. This study also presents a strategy of the precise timing and targeting of SRS to lesions in progression.

Indexed as

Brain NeoplasmsLung NeoplasmsRadiosurgeryErbB ReceptorsHumansRetrospective StudiesEGFR protein, humanErbB ReceptorsBrain metastasesEpidermal growth factor receptorGamma-knifeNon-small cell lung cancerStereotactic radiosurgeryTyrosine-kinase inhibitor

Identifiers

PMID37656378
OpenAlexW4386347406

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.