Evidence map›Paper›PMID 42265433›Full record

ArticleJournal of neuro-oncology2026

Survival after hypofractionated radiation versus standard radiation in glioblastoma by MGMT promoter methylation status and age: an analysis of the national cancer database.

Megan Parker, Austin Carmichael, Calixto-Hope G Lucas, Karisa C Schreck, Kristin J Redmond, Lawrence R Kleinberg, Jordina Rincon-Torroella

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Megan ParkerDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street Phipps Building, Suite 123, Baltimore, MD, 21287, USA.
Austin CarmichaelDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street Phipps Building, Suite 123, Baltimore, MD, 21287, USA.
Calixto-Hope G LucasDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Karisa C SchreckDepartments of Neurology and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kristin J RedmondDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, USA.
Lawrence R KleinbergDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, USA.
Jordina Rincon-TorroellaDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street Phipps Building, Suite 123, Baltimore, MD, 21287, USA. jrincon2@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHypofractionated radiotherapy (HFRT) is recommended by NCCN and EANO guidelines for elderly patients with glioblastoma, but large real-world comparisons with standard fractionated radiotherapy (SFRT) are limited. We evaluated the association between HFRT and survival among patients with glioblastoma, stratified by elderly status and MGMT promoter (MGMTp) methylation, in a national cancer registry.

methodsIn this retrospective cohort study of the 2022 National Cancer Database, we identified 2,401 elderly (≥ 70 years) and 4,944 non-elderly (< 70 years) patients with histologically confirmed glioblastoma. Overall survival was compared between HFRT (40 Gy/15 fractions) and SFRT (60 Gy/30 fractions) with Kaplan-Meier and multivariable Cox proportional hazards analyses stratified by age, MGMTp methylation, and chemotherapy status. Covariables included demographic variables, Charlson-Deyo score, extent of resection, and tumor size.

resultsAmong elderly patients, 1,432 received HFRT and 969 received SFRT. Kaplan-Meier analysis indicated a survival advantage for elderly individuals who received SFRT plus chemotherapy compared to those who received HFRT plus chemotherapy (15.01 versus 10.71 months, p < 0.001), regardless of MGMTp methylation. However, multivariable analyses revealed no survival difference between HFRT and SFRT in elderly individuals across all chemotherapy and MGMTp subgroupings. Among non-elderly patients (557 HFRT; 4,387 SFRT), both Kaplan-Meier and multivariable analyses demonstrated shorter survival with HFRT across chemotherapy and MGMTp subgroups.

conclusionSFRT was associated with longer survival in non-elderly patients, possibly reflecting selection of poorer-risk patients for HFRT. In elderly patients, HFRT was noninferior regardless of MGMTp status, supporting its use as a less intensive approach with comparable survival and reduced treatment burden.

Indexed as

Brain NeoplasmsDNA MethylationDNA Modification MethylasesDNA Repair EnzymesGlioblastomaRadiation Dose HypofractionationTumor Suppressor ProteinsAdultAgedAged, 80 and overAge FactorsDatabases, FactualFemaleFollow-Up StudiesHumansMaleDNA Modification MethylasesDNA Repair EnzymesMGMT protein, humanTumor Suppressor ProteinsChemoradiationElderlyGlioblastomaHypofractionated radiotherapyMGMTNCDBSurvival

Identifiers

PMID42265433

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.