Evidence map›Paper›PMID 42199528›Full record

ArticleAdvances in radiation oncology2026

RAPid simPLE (RAPPLE) Targeted Radiation Treatment Versus Whole Brain Radiation Therapy: A Retrospective Cohort Study of Matched Patients With Brain Metastases and Poor Prognosis.

Gurjit S Parmar, Tim Kong, Richard Musoke, Jeremy Hamm, Mitchell Liu, Shilo Lefresne, Hannah Carolan, Eric Berthelet, Jessica Chan, Alan M Nichol

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In one paragraph

Article in Advances in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Gurjit S ParmarFaculty of Medicine, Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
Tim KongFaculty of Medicine, Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
Richard MusokeBC Cancer, Vancouver, British Columbia, Canada.
Jeremy HammBC Cancer, Vancouver, British Columbia, Canada.
Mitchell LiuFaculty of Medicine, Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
Shilo LefresneFaculty of Medicine, Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
Hannah CarolanFaculty of Medicine, Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
Eric BertheletFaculty of Medicine, Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
Jessica ChanFaculty of Medicine, Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
Alan M NicholFaculty of Medicine, Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Patients with brain metastases whose poor prognosis does not warrant stereotactic radiosurgery (SRS) often receive whole brain radiation therapy (WBRT). We compared the outcomes of patients treated with a novel brain-sparing radiation therapy technique with those of matched patients treated with WBRT. Methods and Materials: RAPid simPLE (RAPPLE) uses single-isocenter, coplanar volumetric modulated arc therapy to target brain metastases with 20 Gy in 5 fractions. Patients treated with a first course of RAPPLE between January 1, 2017, and November 5, 2021, were identified in an institutional database. Using age, cancer diagnosis, number of brain metastases, and treatment date, we 1:1-matched patients who received RAPPLE and WBRT. Endpoints were overall survival, calculated using the Kaplan-Meier method, and cumulative incidence of intracranial progression with a competing risk of death. Log-rank, Gray's test, Cox regression, and Fine-Gray analyses were used for comparisons. Ten cases were randomly selected from an institutional database, each representing a unique lesion count from 1 to 10 brain metastases, and treated with 35Gy in 5 fractions using linear accelerator SRS. These were replanned using RAPPLE to compare the mean dose to the brain minus gross tumor volume. Results: The study cohort comprised 248 patients. Median survival was 4.5 months for RAPPLE and 4.0 months for WBRT (log-rank Conclusions: There was no difference in survival between the matched groups. RAPPLE spares normal brain volume to a degree analogous to that seen with SRS. Among patients treated with RAPPLE, 97% avoided WBRT.

Identifiers

PMID42199528
PMCPMC13199668

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