ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2018
Improved effectiveness of stereotactic radiosurgery in large brain metastases by individualized isotoxic dose prescription: an in silico study.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 30 citations in OpenAlex.
- SAFESTEREO: phase II randomized trial to compare stereotactic radiosurgery with fractionated stereotactic radiosurgery for brain metastases.BMC cancer · 2023Trial
- Predicting Radionecrosis After Stereotactic Radiation Therapy for Solitary Brain Metastases: External Validation of a Univariable Model and Development of a Multivariable Model.Advances in radiation oncology · 2025Article
- Hypoxia-informed RBE-weighted beam orientation optimization for intensity modulated proton therapy.Medical physics · 2024Article
- Radiosurgery-induced early changes in peritumoral tissue sodium concentration of brain metastases.PloS one · 2024Article
- What if: A retrospective reconstruction of resection cavity stereotactic radiosurgery to mimic neoadjuvant stereotactic radiosurgery.Frontiers in oncology · 2023Article
- The impact of target positioning error and tumor size on radiobiological parameters in robotic stereotactic radiosurgery for metastatic brain tumors.Radiological physics and technology · 2022Article
- Article
- New curative approach using embolization followed by moderate-dose radiotherapy after surgical failure for large right heart metastasis.Clinical and translational radiation oncology · 2022Article
- Quality of Automated Stereotactic Radiosurgery Plans in Patients with 4 to 10 Brain Metastases.Cancers · 2021Article
- Radiobiological evaluation considering setup error on single-isocenter irradiation in stereotactic radiosurgery.Journal of applied clinical medical physics · 2021Article
- Tumor-dose-rate variations during robotic radiosurgery of oligo and multiple brain metastases.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Article
- Impact of PTV margin reduction (2 mm to 0 mm) on pseudoprogression in stereotactic radiotherapy of solitary brain metastases.Technical innovations & patient support in radiation oncology · 2021Article
- The individual risk of symptomatic radionecrosis after brain metastasis radiosurgery is predicted by a continuous function of the V12Gy.Clinical and translational radiation oncology · 2021Article
- Effect of setup error in the single-isocenter technique on stereotactic radiosurgery for multiple brain metastases.Journal of applied clinical medical physics · 2020Article
- Risk of radiation necrosis after hypofractionated stereotactic radiotherapy (HFSRT) for brain metastases: a single center retrospective study.Journal of neuro-oncology · 2020Article
- FSRT vs. SRS in Brain Metastases-Differences in Local Control and Radiation Necrosis-A Volumetric Study.Frontiers in oncology · 2020Article
- Noncoplanar VMAT for Brain Metastases: A Plan Quality and Delivery Efficiency Comparison With Coplanar VMAT, IMRT, and CyberKnife.Technology in cancer research & treatment · 2019Article
- Postoperative local fractionated radiotherapy for resected single brain metastases.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2018Article
- Stereotactic Radiosurgery in the Management of Patients With Brain Metastases of Non-Small Cell Lung Cancer: Indications, Decision Tools and Future Directions.Frontiers in oncology · 2018Review
- A Dutch phase III randomized multicenter trial: whole brain radiotherapy versus stereotactic radiotherapy for 4-10 brain metastases.Neuro-oncology advancesArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
introductionIn large brain metastases (BM) with a diameter of more than 2 cm there is an increased risk of radionecrosis (RN) with standard stereotactic radiosurgery (SRS) dose prescription, while the normal tissue constraint is exceeded. The tumor control probability (TCP) with a single dose of 15 Gy is only 42%. This in silico study tests the hypothesis that isotoxic dose prescription (IDP) can increase the therapeutic ratio (TCP/Risk of RN) of SRS in large BM. MATERIALS AND
methodsA treatment-planning study with 8 perfectly spherical and 46 clinically realistic gross tumor volumes (GTV) was conducted. The effects of GTV size (0.5-4 cm diameter), set-up margins (0, 1, and 2 mm), and beam arrangements (coplanar vs non-coplanar) on the predicted TCP using IDP were assessed. For single-, three-, and five-fraction IDP dose-volume constraints of V
resultsIn BM of 4 cm in diameter, the maximum achievable single-fraction IDP dose was 14 Gy compared to 15 Gy for standard SRS dose prescription, with respective TCPs of 32 and 42%. Fractionated SRS with IDP was needed to improve the TCP. For three- and five-fraction IDP, a maximum predicted TCP of 55 and 68% was achieved respectively (non-coplanar beams and a 1 mm GTV-PTV margin).
conclusionsUsing three-fraction or five-fraction IDP the predicted TCP can be increased safely to 55 and 68%, respectively, in large BM with a diameter of 4 cm with a low risk of RN. Using IDP, the therapeutic ratio of SRS in large BM can be increased compared to current SRS dose prescription.
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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.