Trial reportJournal of neuro-oncology2013
The efficacy and limitations of stereotactic radiosurgery as a salvage treatment after failed whole brain radiotherapy for brain metastases.
Trial report in Journal of neuro-oncology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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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.
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.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Treatment modalities in recurrent brain metastases: a combined institutional and individual patient data meta-analysis of post-recurrence survival and local progression-free survival.Journal of neuro-oncology · 2025Pooled it
- Factors associated with the local control of brain metastases: a systematic search and machine learning application.BMC medical informatics and decision making · 2024Pooled it
- Multidisciplinary management strategies for recurrent brain metastasis after prior radiotherapy: An overview.Neuro-oncology · 2025Review
- Opportunities and Alternatives of Modern Radiation Oncology and Surgery for the Management of Resectable Brain Metastases.Cancers · 2023Review
- Validation and comparison of Breast Graded Prognostic Assessment scores in patients with breast cancer and brain metastases.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021Article
- Laser interstitial thermal therapy as an adjunct therapy in brain tumors: A meta-analysis and comparison with stereotactic radiotherapy.Surgical neurology international · 2020Review
- Adaptive hypofractionated gamma knife radiosurgery in the acute management of brainstem metastases.Surgical neurology international · 2019Article
- Linac-Based Radiosurgery for Patients With Brain Oligometastases From a Breast Primary, in the Trastuzumab Era-Impact of Tumor Phenotype and Prescribed SRS Dose.Frontiers in oncology · 2019Article
- Local control and overall survival after frameless radiosurgery: A single center experience.Clinical and translational radiation oncology · 2017Article
- Brain metastasis reirradiation in patients with advanced breast cancer.Journal of radiation research · 2017Article
- Article
- [Surgery for metastases, anatomical and ethical limits. Special aspect: oligometastases].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2016Review
- Adaptive hypofractionated gamma knife radiosurgery for a large brainstem metastasis.Surgical neurology international · 2016Article
- Treatment of Brain Metastases.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2015Review
- Stereotactic radiosurgery for brain metastasis in non-small cell lung cancer.Radiation oncology journal · 2015Article
- Central nervous system metastasis from breast cancer.The oncologist · 2015Article
- Stereotactic radiosurgery for treatment of brain metastases. A report of the DEGRO Working Group on Stereotactic Radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2014Review
- Stereotactic radiosurgery boost to the resection cavity for cerebral metastases: Report of overall survival, complications, and corticosteroid protocol.Surgical neurology international · 2013Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of the present study was to evaluate the efficacy and limitations of repeat stereotactic radiosurgery (SRS) salvage for patients with recurrence of brain metastases (BM) after whole brain radiotherapy (WBRT). This is a retrospective, observational, single-center trial analyzing 77 consecutive patients with recurrent BM who were treated primarily with WBRT. All patients underwent SRS as salvage treatment. Median age was 62 years, and median Karnofsky performance status (KPS) was 80. The median interval between the starting date of WBRT and radiosurgery was 10.6 months. One, two and more than two SRS sessions were required in 42, 13 and 22 patients, respectively. The median total planning target volume (PTV) was 8.1 mL and the median dose prescribed was 20 Gy. The median follow-up was 7.7 months. 1- and 2-year neurological death-free survival (NS) rates were 87 and 78 %, respectively. Competing risk analysis demonstrated active extra-central nervous system (CNS) disease [Hazard ratio (HR) 0.236, P = 0.041] and total PTV on initial SRS (≥ 5 mL) (HR 4.22, P = 0.033) to be associated with the NS rate. 1- and 2-year overall survival (OS) rates were 41 and 11 %, respectively. The median OS time was 8.2 months. Active extra-CNS disease (HR 1.94, P = 0.034) and high KPS (≥ 90) (HR 0.409, P = 0.006) were associated with the OS rate. In total, 798 tumors (75 %) in 66 patients (86 %) with sufficient radiological follow-up data were evaluated. 1- and 2-year metastasis local control rates were 76.6 and 57.9 %, respectively. Prescribed dose (≥ 20 Gy) (HR 0.326, P < 0.001), tumor volume (≥ 2 mL) (HR 1.98, P = 0.007) and metastases from breast cancer (HR 0.435, P < 0.001) were independent predictive factors for local tumor control. Repeat salvage SRS for recurrent BM after WBRT appeared to be a safe and effective treatment. In the majority of patients, even those with numerous BM, neurological death could be delayed or even prevented.
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