Critical appraisal:Rades D, Sehmisch L, Huttenlocher S, Blank O, Hornung D, Terheyden P, et al 2014
Critical Appraisal
Rades D, Sehmisch L, Huttenlocher S, Blank O, Hornung D, Terheyden P, et al. Radiosurgery alone for 1-3 newly-diagnosed brain metastases from melanoma: impact of dose on treatment outcomes. Anticancer Res 2014 Sep;34(9):5079-82 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25202094.
Key Facts
cohort study
To compare different doses of stereotactic radiosurgery for 1-3 newly-diagnosed cerebral metastases from melanoma.
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Two groups were designed according to the dose administered to the margin of the metastatic lesions: 20 Gy (n=36) and 21-22.5 Gy (n=18).
Treatment outcomes, including local control of the irradiated metastases, freedom from new brain metastases and overall survival.
The local control rates of the entire cohort at 6 months and 12 months following SRS were 89% and 81%, respectively.
In univariate analysis, improved local control of the irradiated metastases was significantly associated with SRS doses of 21-22.5 Gy (p= 0.020) and normal pre-radiotherapy LDH levels (p= 0.024).
Local control for SRS dose of 21 Gy was 83% and 72% for 6 month and 12 month respectively; and a SRS dose of 21-22.5 Gy was 100% for local control at 6 and 12 months.
The overall survival rates of the entire cohort at 6 and 12 months following SRS were 67% and 49%, respectively. In the univariate analysis overall survival was not associated with SRS dose (p=0.13). Overall survival for SRS dose of 20 Gy was 64% at 6 months and 42% at 12 months; and for a SRS dose of 21-22.5 Gy the 6 month and 12 month overall survival were 72% and 65%, respectively.
no
Evidence ratings
III-2
Moderate risk of bias | Comments: Please replace this text and include any additional comments in regards to your risk of bias rating |
- Article
- Rades D, Sehmisch L, Huttenlocher S, Blank O, Hornung D, Terheyden P, et al. Radiosurgery alone for 1-3 newly-diagnosed brain metastases from melanoma: impact of dose on treatment outcomes. Anticancer Res 2014 Sep;34(9):5079-82 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25202094.
- Assigned to
- User:Tamsin.parrish
- Topic area
- Guidelines:Melanoma
- Clinical question
Section below only relevant for Cancer Council Project Officer