Effects of Surgery With Salvage Stereotactic Radiosurgery Versus Surgery With Whole-Brain Radiation Therapy in Patients With One to Four Brain Metastases (JCOG0504): A Phase III, Noninferiority, Randomized Controlled Trial Article Swipe
Takamasa Kayama
,
Shinya Sato
,
Kaori Sakurada
,
Junki Mizusawa
,
Ryo Nishikawa
,
Yoshitaka Narita
,
Minako Sumi
,
Yasuji Miyakita
,
Toshihiro Kumabe
,
Yukihiko Sonoda
,
Yoshiki Arakawa
,
Susumu Miyamoto
,
Takaaki Beppu
,
Kazuhiko Sugiyama
,
Hirohiko Nakamura
,
Motoo Nagane
,
Yoko Nakasu
,
Naoya Hashimoto
,
Mizuhiko Terasaki
,
Akira Matsumura
,
Eiichi Ishikawa
,
Toshihiko Wakabayashi
,
Yasuo Iwadate
,
Shiro Ohue
,
Hiroyuki Kobayashi
,
Manabu Kinoshita
,
Kenichiro Asano
,
Akitake Mukasa
,
Katsuyuki Tanaka
,
Akio Asai
,
Hideo Nakamura
,
Tatsuya Abé
,
Yoshihiro Muragaki
,
Koichi Iwasaki
,
Tomokazu Aoki
,
Takao Watanabe
,
Hikaru Sasaki
,
Shuichi Izumoto
,
Masahiro Mizoguchi
,
Takayuki Matsuo
,
Hideo Takeshima
,
Motohiro Hayashi
,
Hidefumi Jokura
,
Takashi Mizowaki
,
Eiji Shimizu
,
Hiroki Shirato
,
Masao Tago
,
Hiroshi Katayama
,
Haruhiko Fukuda
,
Soichiro Shibui
·
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1200/jco.2018.78.6186
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1200/jco.2018.78.6186
Purpose Whereas whole-brain radiotherapy (WBRT) has been the standard treatment of brain metastases (BMs), stereotactic radiosurgery (SRS) is increasingly preferred to avoid cognitive dysfunction; however, it has not been clearly determined whether treatment with SRS is as effective as that with WBRT or WBRT plus SRS. We thus assessed the noninferiority of salvage SRS to WBRT in patients with BMs. Patients and Methods Patients age 20 to 79 years old with performance status scores of 0 to 2—and 3 if caused only by neurologic deficits—and with four or fewer surgically resected BMs with only one lesion > 3 cm in diameter were eligible. Patients were randomly assigned to WBRT or salvage SRS arms within 21 days of surgery. The primary end point was overall survival. A one-sided α of .05 was used. Results Between January 2006 and May 2014, 137 and 134 patients were enrolled in the WBRT and salvage SRS arms, respectively. Median overall survival was 15.6 months in both arms (hazard ratio, 1.05; 90% CI, 0.83 to 1.33; one-sided P for noninferiority = .027). Median intracranial progression-free survival of patients in the WBRT arm (10.4 months) was longer than that of patients in the salvage SRS arm (4.0 months). The proportions of patients whose Mini-Mental Status Examination and performance status scores that did not worsen at 12 months were similar in both arms; however, 16.4% of patients in the WBRT arm experienced grade 2 to 4 cognitive dysfunction after 91 days postenrollment, whereas only 7.7% of those in the SRS arm did ( P = .048). Conclusion Salvage SRS is noninferior to WBRT and can be established as a standard therapy for patients with four or fewer BMs.
Related Topics
Concepts
Medicine
Radiosurgery
Clinical endpoint
Surgery
Randomized controlled trial
Hazard ratio
Salvage therapy
Whole brain radiotherapy
Radiation therapy
Brain metastasis
Internal medicine
Cancer
Confidence interval
Chemotherapy
Metastasis
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1200/jco.2018.78.6186
- https://ascopubs.org/doi/pdfdirect/10.1200/JCO.2018.78.6186
- OA Status
- bronze
- Cited By
- 178
- References
- 26
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2809415964
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W2809415964Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1200/jco.2018.78.6186Digital Object Identifier
- Title
-
Effects of Surgery With Salvage Stereotactic Radiosurgery Versus Surgery With Whole-Brain Radiation Therapy in Patients With One to Four Brain Metastases (JCOG0504): A Phase III, Noninferiority, Randomized Controlled TrialWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2018Year of publication
- Publication date
-
2018-06-20Full publication date if available
- Authors
-
Takamasa Kayama, Shinya Sato, Kaori Sakurada, Junki Mizusawa, Ryo Nishikawa, Yoshitaka Narita, Minako Sumi, Yasuji Miyakita, Toshihiro Kumabe, Yukihiko Sonoda, Yoshiki Arakawa, Susumu Miyamoto, Takaaki Beppu, Kazuhiko Sugiyama, Hirohiko Nakamura, Motoo Nagane, Yoko Nakasu, Naoya Hashimoto, Mizuhiko Terasaki, Akira Matsumura, Eiichi Ishikawa, Toshihiko Wakabayashi, Yasuo Iwadate, Shiro Ohue, Hiroyuki Kobayashi, Manabu Kinoshita, Kenichiro Asano, Akitake Mukasa, Katsuyuki Tanaka, Akio Asai, Hideo Nakamura, Tatsuya Abé, Yoshihiro Muragaki, Koichi Iwasaki, Tomokazu Aoki, Takao Watanabe, Hikaru Sasaki, Shuichi Izumoto, Masahiro Mizoguchi, Takayuki Matsuo, Hideo Takeshima, Motohiro Hayashi, Hidefumi Jokura, Takashi Mizowaki, Eiji Shimizu, Hiroki Shirato, Masao Tago, Hiroshi Katayama, Haruhiko Fukuda, Soichiro ShibuiList of authors in order
- Landing page
-
https://doi.org/10.1200/jco.2018.78.6186Publisher landing page
- PDF URL
-
https://ascopubs.org/doi/pdfdirect/10.1200/JCO.2018.78.6186Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
-
https://ascopubs.org/doi/pdfdirect/10.1200/JCO.2018.78.6186Direct OA link when available
- Concepts
-
Medicine, Radiosurgery, Clinical endpoint, Surgery, Randomized controlled trial, Hazard ratio, Salvage therapy, Whole brain radiotherapy, Radiation therapy, Brain metastasis, Internal medicine, Cancer, Confidence interval, Chemotherapy, MetastasisTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
178Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 14, 2024: 27, 2023: 33, 2022: 31, 2021: 24Per-year citation counts (last 5 years)
- References (count)
-
26Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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