Evidence map›Paper›PMID 39095756›Full record

ArticleBMC cancer2024

The indication of palliative whole-brain radiotherapy for patients with brain metastases: a simple prognostic scoring system in the era of stereotactic radiosurgery.

Toshiaki Hirose, Shoichi Deguchi, Kazuaki Yasui, Minoru Inoue, Tsuyoshi Onoe, Hirofumi Ogawa, Hirofumi Asakura, Koichi Mitsuya, Hideyuki Harada, Shigeyuki Murayama and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

13 authors.

Toshiaki HiroseDivision of Neurosurgery, Shizuoka Cancer Center, Nagaizumi, Japan.
Shoichi DeguchiDivision of Neurosurgery, Shizuoka Cancer Center, Nagaizumi, Japan. deguchi.shoichi.z9@f.mail.nagoya-u.ac.jp.
Kazuaki YasuiRadiation and Proton Therapy Center, Shizuoka Cancer Center, Nagaizumi, Japan.
Minoru InoueRadiation and Proton Therapy Center, Shizuoka Cancer Center, Nagaizumi, Japan.
Tsuyoshi OnoeRadiation and Proton Therapy Center, Shizuoka Cancer Center, Nagaizumi, Japan.
Hirofumi OgawaRadiation and Proton Therapy Center, Shizuoka Cancer Center, Nagaizumi, Japan.
Hirofumi AsakuraRadiation and Proton Therapy Center, Shizuoka Cancer Center, Nagaizumi, Japan.
Koichi MitsuyaDivision of Neurosurgery, Shizuoka Cancer Center, Nagaizumi, Japan.
Hideyuki HaradaRadiation and Proton Therapy Center, Shizuoka Cancer Center, Nagaizumi, Japan.
Shigeyuki MurayamaRadiation and Proton Therapy Center, Shizuoka Cancer Center, Nagaizumi, Japan.
Nakamasa HayashiDivision of Neurosurgery, Shizuoka Cancer Center, Nagaizumi, Japan.
Tetsuo NishimuraRadiation and Proton Therapy Center, Shizuoka Cancer Center, Nagaizumi, Japan.
Ryuta SaitoDepartment of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Aichi, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStereotactic irradiation has become the mainstay treatment for brain metastases (BM), and whole-brain radiotherapy (WBRT) is often used for symptom palliation. However, the survival time of patients with BM undergoing palliative WBRT (pWBRT) is limited, making it difficult to select patients who should receive treatment.

methodsWe collected patient data from 2016 to 2022 at the Shizuoka Cancer Center and retrospectively analyzed the factors related to survival time. Overall survival (OS) was defined as the survival time after WBRT.

resultsA total of 301 patients (median age, 66 years) who underwent pWBRT were included. The primary cancers were lung, breast, gastrointestinal tract, and other cancers in 203 (67%), 38 (13%), 33 (11%), and 27 (9%) patients, respectively. Median OS of all patients was 4.1 months. In the multivariate analysis, male sex (hazard ratio [HR]:1.4), Karnofsky Performance Status (KPS) ≤ 60 (HR:1.7), presence of extracranial metastasis (ECM) (HR:1.6), neutrophil-lymphocyte ratio (NLR) ≥ 5 (HR:1.6), and lactate dehydrogenase (LDH) ≥ upper limit of normal (ULN) (HR:1.3) were significantly associated with shorter OS (all P < 0.05). To predict the OS, we created a prognostic scoring system (PSS). We gave one point to each independent prognostic factor. Median OS for patients with scores of 0-2, 3, and 4-5 were 9.0, 3.5 and 1.7 months, respectively (P < 0.001).

conclusionsMale sex, KPS ≤ 60, presence of ECM, NLR ≥ 5, and LDH ≥ ULN were poor prognostic factors for patients with BM undergoing pWBRT. By PSS combining these factors, it may be possible to select patients who should undergo pWBRT.

Indexed as

Brain NeoplasmsCranial IrradiationPalliative CareRadiosurgeryAdultAgedAged, 80 and overFemaleHumansKarnofsky Performance StatusMaleMiddle AgedPrognosisRetrospective StudiesBrain metastasesCancerPalliative whole brain radiotherapyPrognostic scoring system

Identifiers

PMID39095756
PMCPMC11295614

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LicenceCC BY-NC-ND
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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.