Critical appraisal:Borgelt B, Gelber R, Kramer S, Brady LW, Chang CH, Davis LW, et al 1980

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Critical Appraisal

Article being appraised

Borgelt B, Gelber R, Kramer S, Brady LW, Chang CH, Davis LW, et al. The palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 1980 Jan;6(1):1-9 Available from: http://www.ncbi.nlm.nih.gov/pubmed/6154024.


Applicable clinical question

Key Facts

Study Design

randomised controlled trial

Number of Patients:

1812


Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
Moderate risk of bias Comments: 2 large RCT (910 and 902 patients. Method of randomisation not stated. Unclear whether ITT analysis. Length or frequency of FU not stated.


Size of effect
1 Reason for decision: RCT of different fractionation schemes of WBRT. But old study where brain mets confirmed by clinical symptoms, EEG, radioisotope brain scan not CT or MRI. Included brain mets from all primaries but sig no of lung cancer patients. Clinically important effect. 60-90% improvement in neurological symptoms. Palliative index - 75-80% of remaining life spent in improved or stable neurological state. Median survival 15-18w.
Relevance of evidence
1 Additional comments: Patient relevant clinical outcomes measured ie neurological symptom relief and survival
Result of appraisal

Jutta's tick icon.png Included




Completed by

Associate Professor Shalini Vinod MBBS MD FRANZCR


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Article
Borgelt B, Gelber R, Kramer S, Brady LW, Chang CH, Davis LW, et al. The palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 1980 Jan;6(1):1-9 Available from: http://www.ncbi.nlm.nih.gov/pubmed/6154024.
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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