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X Demographics
Mendeley readers
Attention Score in Context
| Title |
Debate: adjuvant whole brain radiotherapy or not? More data is the wiser choice
|
|---|---|
| Published in |
BMC Cancer, July 2016
|
| DOI | 10.1186/s12885-016-2433-8 |
| Pubmed ID | |
| Authors |
Gerald B. Fogarty, Angela Hong, Vinai Gondi, Bryan Burmeister, Kari Jacobsen, Serigne Lo, Elizabeth Paton, Brindha Shivalingam, John F. Thompson |
| Abstract |
Every year 170,000 patients are diagnosed with brain metastases (BMs) in the United States. Traditionally, adjuvant whole brain radiotherapy (AWBRT) has been offered following local therapy with neurosurgery (NSx) and/or stereotactic radiosurgery (SRS) to BMs. The aim is to increase intracranial control, thereby decreasing symptoms from intracranial progression and a neurological death. There is a rapidly evolving change in the radiation treatment of BMs happening around the world. AWBRT is now being passed over in favour of repeat scanning at regular intervals and more local therapies as more BMs appear radiologically, BMs that may never become symptomatic. This change has happened after the American Society for Radiation Oncology (ASTRO) in Item 5 of its "Choosing Wisely 2014" list recommended: "Don't routinely add adjuvant whole brain radiation therapy to SRS for limited brain metastases". The guidelines are supposed to be based on the highest evidence to hand at the time. This article debates that the randomised controlled trials (RCTs) published prior to this recommendation consistently showed AWBRT significantly increases intracranial control, and avoids a neurological death, what it is meant to do. It also points out that, despite the enormity of the problem, only 774 patients in total had been randomised over more than three decades. These trials were heterogeneous in many respects. This data can, at best, be regarded as preliminary. In particular, there are no single histology AWBRT trials yet completed. A phase two trial investigating hippocampal avoiding AWBRT (HAWBRT) showed significantly less NCF decline compared to historical controls. We now need more randomised data to confirm the benefit of adjuvant HAWBRT. However, the ASTRO Guideline has particularly impacted accrual to trials investigating this, especially the international ANZMTG 01.07 WBRTMel trial. This is an RCT investigating AWBRT following local treatment in patients with one to three BMs from melanoma. WBRTMel has accrued 196 of a required 220 to date but accrual has slowed. HAWBRT may now never be tested in a randomised setting. Encouraging more data in AWBRT is the wiser choice. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Australia | 2 | 29% |
| Spain | 2 | 29% |
| Portugal | 1 | 14% |
| Unknown | 2 | 29% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 71% |
| Science communicators (journalists, bloggers, editors) | 1 | 14% |
| Scientists | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 41 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 17% |
| Researcher | 5 | 12% |
| Student > Bachelor | 5 | 12% |
| Student > Ph. D. Student | 4 | 10% |
| Other | 3 | 7% |
| Other | 8 | 20% |
| Unknown | 9 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 18 | 44% |
| Agricultural and Biological Sciences | 3 | 7% |
| Nursing and Health Professions | 2 | 5% |
| Physics and Astronomy | 2 | 5% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Other | 5 | 12% |
| Unknown | 10 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 July 2016.
All research outputs
#6,575,550
of 23,267,128 outputs
Outputs from BMC Cancer
#1,686
of 8,430 outputs
Outputs of similar age
#107,559
of 353,367 outputs
Outputs of similar age from BMC Cancer
#33
of 240 outputs
Altmetric has tracked 23,267,128 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 8,430 research outputs from this source. They receive a mean Attention Score of 4.4. This one has done well, scoring higher than 78% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 353,367 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 240 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.