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
Completed by
- 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
Section below only relevant for Cancer Council Project Officer