ArticlePloS one2018
Repeated in-field radiosurgery for locally recurrent brain metastases: Feasibility, results and survival in a heavily treated patient cohort.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 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.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- DEGRO guideline for personalized radiotherapy of brain metastases and leptomeningeal carcinomatosis in patients with breast cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Guideline
- Immune Checkpoint Inhibitors and Survival Outcomes in Brain Metastasis: A Time Series-Based Meta-Analysis.Frontiers in oncology · 2020Pooled it
- Awake mapping-guided salvage resection for local recurrence or radiation necrosis after stereotactic radiosurgery and radiotherapy for brain metastases.Journal of neuro-oncology · 2026Article
- Repeat stereotactic radiosurgery for treatment of brain metastases locally recurrent following initial radiosurgery.Journal of neuro-oncology · 2025Article
- Repeat stereotactic radiosurgery for recurrent brain metastases: a retrospective comparison of local progression and distant brain metastases after prior radiosurgery.Journal of neuro-oncology · 2025Article
- A Radiogenomic Deep Ensemble Learning Model for Identifying Radionecrosis Following Brain Metastases (BM) Stereotactic Radiosurgery in Patients With Non-small Cell Lung Cancer BM.Advances in radiation oncology · 2025Article
- Multidisciplinary management strategies for recurrent brain metastasis after prior radiotherapy: An overview.Neuro-oncology · 2025Review
- Precision radiotherapy with molecular-profiling of CNS tumours.Journal of neuro-oncology · 2025Review
- Outcomes of Management of Progressive Radiosurgery-Treated Brain Metastasis With Resection Followed by Pathology-Informed Management: A Retrospective Study.Neurosurgery practice · 2024Article
- Novel radiotherapeutic strategies in the management of brain metastases: Challenging the dogma.Neuro-oncology · 2024Review
- The evolving role of reirradiation in the management of recurrent brain tumors.Journal of neuro-oncology · 2023Review
- Effectiveness of Robotic Stereotactic Radiotherapy in Patients Undergoing Re-irradiation: A Review.Cureus · 2023Review
- Opportunities and Alternatives of Modern Radiation Oncology and Surgery for the Management of Resectable Brain Metastases.Cancers · 2023Review
- Stereotactic Radiosurgery as Treatment for Brain Metastases: An Update.Asian journal of neurosurgery · 2023Review
- Acute toxicities and cumulative dose to the brain of repeated sessions of stereotactic radiotherapy (SRT) for brain metastases: a retrospective study of 184 patients.Radiation oncology (London, England) · 2023Article
- Local recurrence and cerebral progression-free survival after multiple sessions of stereotactic radiotherapy of brain metastases: a retrospective study of 184 patients : Statistical analysis.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2022Article
- Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (cSRS) as treatment for brain metastasis that recurred locally after initial radiosurgery (BMRS): a multi-institutional experience.Journal of neuro-oncology · 2022Article
- Factors associated with the use of salvage whole brain radiation therapy versus salvage stereotactic radiosurgery after initial stereotactic radiosurgery for brain metastases.Journal of radiosurgery and SBRT · 2022Article
- Salvage Surgical Resection after Linac-Based Stereotactic Radiosurgery for Newly Diagnosed Brain Metastasis.Current oncology (Toronto, Ont.) · 2021Article
- Salvage resection of recurrent previously irradiated brain metastases: tumor control and radiation necrosis dependency on adjuvant re-irradiation.Journal of neuro-oncology · 2021Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeStereotactic radiosurgery (SRS) is an established primary treatment for newly diagnosed brain metastases with high local control rates. However, data about local re-irradiation in case of local failure after SRS (re-SRS) are rare. We evaluated the feasibility, efficacy and patient selection characteristics in treating locally recurrent metastases with a second course of SRS.
methodsWe retrospectively evaluated patients with brain metastases treated with re-SRS for local tumor progression between 2011 and 2017. Patient and treatment characteristics as well as rates of tumor control, survival and toxicity were analyzed.
resultsOverall, 32 locally recurrent brain metastases in 31 patients were irradiated with re-SRS. Median age at re-SRS was 64.9 years. The primary histology was breast cancer and non-small-cellular lung cancer (NSCLC) in respectively 10 cases (31.3%), in 5 cases malignant melanoma (15.6%). In the first SRS-course 19 metastases (59.4%) and in the re-SRS-course 29 metastases (90.6%) were treated with CyberKnife® and the others with Gamma Knife. Median planning target volume (PTV) for re-SRS was 2.5 cm3 (range, 0.1-37.5 cm3) and median dose prescribed to the PTV was 19 Gy (range, 12-28 Gy) in 1-5 fractions to the median 69% isodose (range, 53-80%). The 1-year overall survival rate was 61.7% and the 1-year local control rate was 79.5%. The overall rate of radiological radio-necrosis was 16.1% and four patients (12.9%) experienced grade ≥ 3 toxicities.
conclusionsA second course of SRS for locally recurrent brain metastases after prior local SRS appears to be feasible with acceptable toxicity and can be considered as salvage treatment option for selected patients with high performance status. Furthermore, this is the first study utilizing robotic radiosurgery for this indication, as an additional option for frameless fractionated treatment.
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