ArticleJournal of neuro-oncology2015
Brainstem metastases treated with stereotactic radiosurgery: safety, efficacy, and dose response.
Article in Journal of neuro-oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05477316 (A Single-arm Pilot Study, to Assess the Efficacy of Cerebellar IMRT Combined With Cerebral SRS in Patients With Brain Metastases That Are Predominantly in the Posterior Fossa - a Novel Treatment Approach), which is not on this map. Cited by 17 papers.
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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.
A Single-arm Pilot Study, to Assess the Efficacy of Cerebellar IMRT Combined With Cerebral SRS in Patients With Brain Metastases That Are Predominantly in the Posterior Fossa - a Novel Treatment Approach
Who cites it
17 citing papers in PubMed, 40 citations in OpenAlex.
- Fractionated stereotactic radiotherapy of brainstem metastases - Clinical outcome and prognostic factors.Clinical and translational radiation oncology · 2025Article
- Association between tumor location and toxicity outcomes after stereotactic radiosurgery for brain metastases.Journal of neuro-oncology · 2025Article
- Outcomes of 2-SSRS plus bevacizumab therapy strategy for brainstem metastases (BSM) over 2 cmNeurosurgical review · 2024Article
- Predicting peritumoral edema development after gamma knife radiosurgery of meningiomas using machine learning methods: a multicenter study.European radiology · 2023Article
- Preoperative Stereotactic Radiosurgery for Glioblastoma.Biology · 2022Review
- Evaluation of patient education materials for stereotactic radiosurgery from high-performing neurosurgery hospitals and professional societies.Neuro-oncology practice · 2020Article
- The case for radiosurgery for brainstem metastases.Journal of neuro-oncology · 2019Article
- Adaptive hypofractionated gamma knife radiosurgery in the acute management of brainstem metastases.Surgical neurology international · 2019Article
- Stereotactic radiosurgery for brain metastases from malignant melanoma and the impact of hemorrhagic metastases.Journal of neuro-oncology · 2018Article
- Article
- Brainstem metastases treated with Gamma Knife stereotactic radiosurgery: the Indiana University Health experience.CNS oncology · 2018Article
- Neurosurgical management of brain metastases.Clinical & experimental metastasis · 2017Review
- Evaluation of outcomes after stereotactic radiosurgery for pilocytic astrocytoma.Journal of neuro-oncology · 2017Article
- First follow-up radiographic response is one of the predictors of local tumor progression and radiation necrosis after stereotactic radiosurgery for brain metastases.Cancer medicine · 2017Article
- Radiotoxicity in robotic radiosurgery: proposing a new quality index for optimizing the treatment planning of brain metastases.Radiation oncology (London, England) · 2017Article
- [Stereotactic radiosurgery for brainstem metastases : In experienced hands a good treatment option with excellent risk-benefit ratio].Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2017Article
- Radiosurgery for brainstem metastases with and without whole brain radiotherapy: clinical series and literature review.Journal of radiation oncology · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The safety and efficacy of stereotactic radiosurgery (SRS) in the brainstem is questioned by some over concern of violating historical brainstem SRS dose tolerance. Our purpose was to report on the clinical outcomes of patients treated at our institution with radiosurgery for brainstem metastases. Patients with metastatic tumors within or directly abutting the brainstem from 1992 to 2014 were analyzed. Patient and tumor characteristics, SRS parameters, and toxicity were recorded and analyzed for associations with local control and survival. Multivariate statistical analysis was performed using Cox proportional hazards modeling. One-hundred and eighty-nine (189) brainstem metastases from 161 patients were included in our analysis. Whole brain irradiation was administered prior to SRS in 52 % of patients. The median margin dose was 18 Gy prescribed to the 50 % isodose line. Median imaging follow up was 5.4 months and median survival was 5.5 months after SRS. At last follow up, local control was achieved in 87.3 % of brainstem lesions treated. There were 3 recorded events of grade 3-5 toxicity (1.8 %). On multivariate analysis, a margin dose ≥16 Gy was associated with improved local control (p = 0.049) and greater KPS score was associated with improved overall survival following SRS (p = 0.024). Patients with brainstem metastases who have limited intracranial disease and/or who have received whole brain irradiation should be considered for SRS. Margin doses of at least 16 Gy are associated with superior local control, and serious radiation toxicity in SRS for brainstem metastasis appears rare.
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Registered trials
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 OpenQuestion graph.