Critical appraisal:Bates JE, Youn P, Usuki KY, Walter KA, Huggins CF, Okunieff P, et al 2015
Critical Appraisal
Bates JE, Youn P, Usuki KY, Walter KA, Huggins CF, Okunieff P, et al. Brain metastasis from melanoma: the prognostic value of varying sites of extracranial disease. J Neurooncol 2015 Nov;125(2):411-8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26354772.
Key Facts
cohort study
To further characterise the role of SRS and/or WBRT in patients with brain-metastatic melanoma in a retrospective manner based on the experience of a single major academic medical institution.
73
Overall survival (OS), progression free survival (PFS), brain progression free survival (BPFS)
The median overall survival (OS) for this cohort was 3 months.
Patients with three or more distinct sites of intracranial disease (n=39, OS= 1.8 months, HR= 1.98, p= 0.005) did significantly worse than those with one or two sites of intracranial disease (n= 34, OS= 7 months).
Patients who received SRS alone (OS= 11.9 months, HR= 0.38, 95% CI 0.21-0.68, p= 0.001) or SRS and WBRT (OS= 3.8 months, HR= 0.51, 95%CI 0.27-0.97, p= 0.04) had improved OS compared to those who received WBRT alone (OS= 1.9 months).
Those patients who received SRS alone (BPFS= 4.0 months, HR= 0.53, 95%CI 0.30-0.91, p= 0.02) had improved BPFS, compared to those who received WBRT alone (BPFS= 1.4 months), while those who received SRS + WBRT (BPFS= 3.2 months, HR= 0.61, 95%CI 0.32-1.16, p= 0.13) had no significant change in BPFS.
no
Evidence ratings
III-2
High risk of bias | Comments: Please replace this text and include any additional comments in regards to your risk of bias rating |
- Article
- Bates JE, Youn P, Usuki KY, Walter KA, Huggins CF, Okunieff P, et al. Brain metastasis from melanoma: the prognostic value of varying sites of extracranial disease. J Neurooncol 2015 Nov;125(2):411-8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26354772.
- Assigned to
- User:Tamsin.parrish
- Topic area
- Guidelines:Melanoma
- Clinical question
Section below only relevant for Cancer Council Project Officer