Evidence map›Paper›PMID 37706200›Full record

ArticleNeuro-oncology advances

Long-term outcomes with reduced-dose whole-brain radiotherapy and a stereotactic radiosurgery boost for primary central nervous system lymphoma.

Bronwen E Foreman, Trey C Mullikin, Scott R Floyd, Chris R Kelsey, Mallika P Patel, Katherine B Peters, John P Kirkpatrick, Zachary J Reitman, Eugene J Vaios

Abstract read
In one paragraph

Article in Neuro-oncology advances. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
  5. Review
  6. 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

9 authors.

Bronwen E ForemanDuke University School of Medicine, Durham, NC, USA.ORCID https://orcid.org/0000-0002-4663-3917
Trey C MullikinDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Scott R FloydDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Chris R KelseyDuke Cancer Institute, Duke University Medical Center, Durham, NC, USA.
Mallika P PatelDepartment of Pharmacy, Duke University Medical Center, Durham, NC, USA.
Katherine B PetersDuke Cancer Institute, Duke University Medical Center, Durham, NC, USA.ORCID https://orcid.org/0000-0001-5110-3868
John P KirkpatrickDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Zachary J ReitmanDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.ORCID https://orcid.org/0000-0002-9122-9550
Eugene J VaiosDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.

Funding

Duke Radiation Oncology and Radiology Stimulating Access to Research in ResidencyR38CA245204 · NCI · DUKE UNIVERSITY · PI FLOYD, SCOTT R · 2020 to 2023
$1.4M
Enhancing the efficacy of Radiation Therapy for brainstem glioma by targeting ATMK08CA256045 · NCI · DUKE UNIVERSITY · PI Zachary Reitman · 2022 to 2026
$1.1M
NCI NIH HHS K08 CA256045NCI NIH HHS R38 CA245204
6 · The paper itself

Abstract

Background: Primary central nervous system lymphoma (PCNSL) is an aggressive diffuse large B-cell lymphoma. Treatment approaches are historically associated with neurotoxicity, particularly with high-dose whole-brain radiotherapy (WBRT). We hypothesized that reduced dose-WBRT (rd-WBRT) followed by a stereotactic radiosurgery (SRS) boost could provide durable disease control without significant adverse effects. Methods: We retrospectively reviewed PCNSL patients treated with rd-WBRT plus an SRS boost at Duke University between 2008 and 2021. Progression-free survival and overall survival (OS) were estimated using competing risk and Kaplan-Meier methods. Results: We identified 23 patients with pathologically confirmed PCNSL. Median age at diagnosis was 69 years (Q1Q3: 52-74) and median Karnofsky Performance Scale (KPS) was 80 (Q1Q3: 70-80). Median follow-up was 21 months. Median doses for rd-WBRT and SRS were 23.4 Gy (Q1Q3: 23.4-23.4) and 12 Gy (Q1Q3: 12-12.5), respectively. The cumulative incidence of intracranial progression at 2 years was 23% (95% CI: 8-42). Six patients (26%) developed distant radiographic progression while 2 patients (9%) developed both distant and local progression. Ten patients (44%) were alive without progression at last follow-up. By Kaplan-Meier estimate, the 2-year OS was 69% (95% CI: 46-84). There were no reported grade 3 + radiation-induced toxicities. Conclusions: The combination of rd-WBRT with an SRS boost appears well-tolerated with durable intracranial control. This approach may represent a treatment option for select patients, such as those with progressive or refractory disease. Further prospective studies are needed to validate these findings and determine whether this approach could be incorporated into consolidation strategies.

Indexed as

primary central nervous system lymphomareduced-dose whole brain radiotherapystereotactic radiosurgery

Identifiers

PMID37706200
PMCPMC10496939

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.