Evidence map›Paper›PMID 39259411›Full record

ArticleJournal of neuro-oncology2024

Predictive value of perilesional edema volume in melanoma brain metastasis response to stereotactic radiosurgery.

Mariya Yavorska, Miriam Tomaciello, Antonio Sciurti, Elisa Cinelli, Giovanni Rubino, Armando Perrella, Alfonso Cerase, Pierpaolo Pastina, Giovanni Luca Gravina, Silvia Arcieri and 7 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Mariya YavorskaUnit of Radiation Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
Miriam TomacielloRadiation Oncology, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
Antonio SciurtiDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Elisa CinelliUnit of Radiation Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
Giovanni RubinoUnit of Radiation Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
Armando PerrellaUnit of Neuroradiology, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
Alfonso CeraseUnit of Neuroradiology, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
Pierpaolo PastinaUnit of Neuroradiology, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
Giovanni Luca GravinaDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Silvia ArcieriPoliclinico Umberto I Hospital, Viale del Policlinico, Rome, 00161, Italy.
Maria Antonietta MazzeiUnit of Diagnostic Imaging, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
Giuseppe MigliaraDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Valentina BaccoliniDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Francesco MaramponRadiation Oncology, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
Giuseppe MinnitiRadiation Oncology, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
Anna Maria Di GiacomoCenter for Immuno-Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
Paolo TiniUnit of Radiation Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy. paolo.tini@unisi.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimStereotactic radiotherapy (SRT) is an established treatment for melanoma brain metastases (MBM). Recent evidence suggests that perilesional edema volume (PEV) might compromise the delivery and efficacy of radiotherapy to treat BM. This study investigated the association between SRT efficacy and PEV extent in MBM. MATERIALS AND

methodsThis retrospective study reviewed medical records from January 2020 to September 2023. Patients with up to 5 measurable MBMs, intracranial disease per RANO/iRANO criteria, and on low-dose corticosteroids were included. MRI scans assessed baseline neuroimaging, with PEV analyzed using 3D Slicer. SRT plans were based on MRI-CT fusion, delivering 18-32.5 Gy in 1-5 fractions. Outcomes included intracranial objective response rate (iORR) and survival measures (L-iPFS and OS). Statistical analysis involved decision tree analysis and multivariable logistic regression, adjusting for clinical and treatment variables.

resultsSeventy-two patients with 101 MBM were analyzed, with a mean age of 68.83 years. The iORR was 61.4%, with Complete Response (CR) in 21.8% and Partial Response (PR) in 39.6% of the treated lesions. PEV correlated with KPS, BRAF status, and treatment response. Decision tree analysis identified a PEV cutoff at 0.5 cc, with lower PEVs predicting better responses (AUC = 0.82 sensitivity: 86.7%, specificity:74.4%,). Patients with PEV ≥ 0.5 cc had lower response rates (iORR 44.7% vs. 63.8%, p < 0.001). Median OS was 9.4 months, with L-iPFS of 27 months. PEV significantly impacted survival outcomes.

conclusionsA more extensive PEV was associated with a less favorable outcome to SRT in MBM.

Indexed as

Brain EdemaBrain NeoplasmsMelanomaRadiosurgeryAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedPredictive Value of TestsPrognosisRetrospective StudiesTreatment OutcomeImmunotherapyMelanoma brain metastasisPerilesional edemaRadio-surgeryStereotactic radiotherapy

Identifiers

PMID39259411
PMCPMC11615094

What OpenQuestion holds

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LicenceCC BY
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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.