Critical appraisal:Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, et al 2006

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Critical Appraisal

Article being appraised

Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 2006 Jun 7;295(21):2483-91 Available from: http://www.ncbi.nlm.nih.gov/pubmed/16757720.


Applicable clinical question

Key Facts

Study Design

randomised controlled trial

Number of Patients:

132


Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
Moderate risk of bias Comments: Medium sized RCT, Central randomisation, ITT analysis, Good FU, Trial closed early, insufficient power to detect smaller differences in survival


Size of effect
1 Reason for decision: RCT of SRS (18-25GY) +/- WBRT (30/10). WBRT reduced brain recurrence and improved brain control but did not affect median survival, PS or neurological function.
Relevance of evidence
1 Additional comments: Endpoints of survival, function, recurrence, cause of death. Relevant to adjuvant WBRT question rather than value of SRS question.
Result of appraisal

Jutta's tick icon.png Included




Completed by

Associate Professor Shalini Vinod MBBS MD FRANZCR


Jutta's tick icon.png This appraisal has been completed.


Article
Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 2006 Jun 7;295(21):2483-91 Available from: http://www.ncbi.nlm.nih.gov/pubmed/16757720.
Assigned to
User:Shalini.vinod
Topic area
Guidelines:Lung cancer/Treatment/Non-small-cell stage IV inoperable
Clinical question
Form
Form:Critical appraisal


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