Evidence map›Paper›PMID 38656347›Full record

ArticleNeuro-oncology2024

Phase I trial of dose escalation for preoperative stereotactic radiosurgery for patients with large brain metastases.

Erin S Murphy, Kailin Yang, John H Suh, Jennifer S Yu, Glen Stevens, Lilyana Angelov, Michael A Vogelbaum, Gene H Barnett, Manmeet S Ahluwalia, Gennady Neyman and 2 more

Open access · bronzeAbstract readClinical Trial, Phase I
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
5.4field-weighted citation impact, top 4% 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

12 citing papers in PubMed, 13 citations in OpenAlex.

  1. In Reply to Marwaha, Shepard, and Wegner.Advances in radiation oncology · 2026
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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

12 authors at 3 institutions in 1 country.

Erin S MurphyCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.ORCID 0000-0003-3724-8539
Kailin YangDepartment of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0001-5968-6738
John H SuhCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Jennifer S YuCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Glen StevensCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Lilyana AngelovCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Michael A VogelbaumDepartment of Neuro-Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Gene H BarnettCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Manmeet S AhluwaliaDepartment of Medical Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA.
Gennady NeymanCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Alireza M MohammadiCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Samuel T ChaoCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Cleveland Clinic · USBaptist Hospital of Miami · USMoffitt Cancer Center · US

Funding

Computational Genomic Epidemiology of Cancer (CoGEC) Training ProgramT32CA094186 · NCI · CASE WESTERN RESERVE UNIVERSITY · PI Thomas Louis LaFramboise, Rong Xu · 2017 to 2026
$2.6M
Cleveland Clinic T32CA094186NCI NIH HHS T32 CA094186
6 · The paper itself

Abstract

backgroundSingle-session stereotactic radiosurgery (SRS) or surgical resection alone for brain metastases larger than 2 cm results in unsatisfactory local control. We conducted a phase I trial for brain metastases(>2 cm) to determine the safety of preoperative SRS at escalating doses.

methodsRadiosurgery dose was escalated at 3 Gy increments for 3 cohorts based on maximum tumor dimension starting at: 18 Gy for >2-3 cm, 15 Gy for >3-4 cm, and 12 Gy for >4-6 cm. Dose-limiting toxicity was defined as grade III or greater acute toxicity.

resultsA total of 35 patients/36 lesions were enrolled. For tumor size >2-3 cm, patients were enrolled up to the second dose level (21 Gy); for >3-4 cm and >4-6 cm cohorts the third dose level (21 and 18 Gy, respectively) was reached. There were 2 DLTs in the >3-4 cm arm at 21 Gy. The maximum tolerated dose of SRS for >2-3 cm was not reached; and was 18 Gy for both >3-4 cm arm and >4-6 cm arm. With a median follow-up of 64.0 months, the 6- and 12-month local control rates were 85.9% and 76.6%, respectively. One patient developed grade 3 radiation necrosis at 5 months. The 2-year rate of leptomeningeal disease (LMD) was 0%.

conclusionsPreoperative SRS with dose escalation followed by surgical resection for brain metastases greater than 2 cm in size demonstrates acceptable acute toxicity. The phase II portion of the trial will be conducted at the maximum tolerated SRS doses.

Indexed as

Brain NeoplasmsRadiosurgeryAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMaximum Tolerated DoseMiddle AgedPreoperative CareRadiotherapy Dosagebrain metastasesdose escalationneoadjuvantpreoperativestereotactic radiosurgery

Identifiers

PMID38656347
PMCPMC11376451
OpenAlexW4395064604

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.