Critical appraisal:Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, et al 2004
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Critical Appraisal
Article being appraised
Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 2004 May 22;363(9422):1665-72 Available from: http://www.ncbi.nlm.nih.gov/pubmed/15158627.
Applicable clinical question
Key Facts
Study Design
randomised controlled trial
Number of Patients:
333
Includes an economic evaluation
no
Evidence ratings
Level of evidence
II
Risk of bias
| Low risk of bias | Comments: Large RTOG RCT.Central randomisation. Good FU. ITT analysis. |
Size of effect
| 1 | Reason for decision: RCT of WBRT (37.5/15) +/- SRS boost for patients with 1-3 mets. No differences in mean survival, TTP or neurological death rates. Patients with SRS had improved PS and reduced steroid use at 6m. Patients with solitary met had improved mean survival with SRS (6.5vs4.9m) |
Relevance of evidence
| 1 | Additional comments: Endpoints of survival, also response, local control, performance status. |
Result of appraisal
Included
Completed by
This appraisal has been completed.
- Article
- Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 2004 May 22;363(9422):1665-72 Available from: http://www.ncbi.nlm.nih.gov/pubmed/15158627.
- Assigned to
- User:Shalini.vinod
- Topic area
- Guidelines:Lung cancer/Treatment/Non-small-cell stage IV inoperable
- Clinical question
Section below only relevant for Cancer Council Project Officer