ArticleInternational journal of radiation oncology, biology, physics2018
Proton Stereotactic Radiosurgery for Brain Metastases: A Single-Institution Analysis of 370 Patients.
Article in International journal of radiation oncology, biology, physics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Proton beam therapy indications in the Kingdom of Saudi Arabia: A SARO clinical practice guideline.Saudi medical journal · 2025Guideline
- A beam model and Boltzmann solver for radiotherapy treatment planning of superficial brain metastases using a scanned electron beam at ultra-high (FLASH) dose rate.Physics in medicine and biology · 2026Article
- Epilepsy in Patients with Cerebral Radiation Necrosis: A Scoping Review.Medicina (Kaunas, Lithuania) · 2026Article
- Stereotactic radiotherapy for brain metastases: indications, dose fractionation, technological innovations, and evolving combination strategies - a comprehensive review.Frontiers in oncology · 2026Review
- Advances in proton therapy technology and global clinical applications.Frontiers in oncology · 2026Review
- Tailored radiotherapy for brain metastases improves precision and outcomes.Discover oncology · 2025Review
- Seizure risk factors and management approaches in patients with brain metastases.Neuro-oncology practice · 2025Review
- HyperSHArc: Single-Isocenter Stereotactic Radiosurgery of Multiple Brain Metastases Using Proton, Helium, and Carbon Ion Arc Therapy.Advances in radiation oncology · 2025Article
- Modelling small block aperture in an in-house developed GPU-accelerated Monte Carlo-based dose engine for pencil beam scanning proton therapy.Physics in medicine and biology · 2024Article
- Comprehensive assessment of proton plans with three different beam delivery systems for multiple brain metastases.Journal of radiosurgery and SBRT · 2024Article
- Neurotoxicity from Old and New Radiation Treatments for Brain Tumors.International journal of molecular sciences · 2023Review
- Proton Beam Therapy in the Oligometastatic/Oligorecurrent Setting: Is There a Role? A Literature Review.Cancers · 2023Review
- Review
- Impact of multidisciplinary team on the pattern of care for brain metastasis from breast cancer.Frontiers in oncology · 2023Article
- Evaluation of improvements in plan quality with Photon Optimizer v16.1 for single brain lesion SRS treatment.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2023Article
- It is beneficial to invest resources to implement proton intracranial SRS.Journal of applied clinical medical physics · 2022Article
- Is it beneficial to use apertures in proton radiosurgery with a scanning beam? A dosimetric comparison in neurinoma and meningioma patients.Journal of applied clinical medical physics · 2022Article
- Novel treatments in optic pathway gliomas.Frontiers in ophthalmology · 2022Review
- Redefine the Role of Spot-Scanning Proton Beam Therapy for the Single Brain Metastasis Stereotactic Radiosurgery.Frontiers in oncology · 2022Article
- Special stereotactic radiotherapy techniques: procedures and equipment for treatment simulation and dose delivery.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2022Review
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo report the first series of proton stereotactic radiosurgery (SRS) for the treatment of patients with single or multiple brain metastases, including failure patterns, survival outcomes, and toxicity analysis. METHODS AND MATERIALS: This was a single-institution, retrospective study of 815 metastases from 370 patients treated with proton SRS between April 1991 and November 2016. Cumulative incidence estimates of local failure, distant brain failure, and pathologically confirmed radionecrosis and Kaplan-Meier estimates of overall survival were calculated. Fine and Gray and Cox regressions were performed to ascertain whether clinical and treatment factors were associated with the described endpoints.
resultsThe median follow-up from proton SRS was 9.2 months. The 6- and 12-month estimates of local failure, distant brain failure, and overall survival were 4.3% (95% confidence interval [CI] 3.0%-5.9%) and 8.5% (95% CI 6.7%-10.6%), 39.1% (95% CI 34.1%-44.0%) and 48.2% (95% CI 43.0%-53.2%), and 76.0% (95% CI 71.3%-80.0%) and 51.5% (95% CI 46.3%-56.5%), respectively. The median survival was 12.4 months (95% CI 10.8-14.0 months) after proton SRS. The most common symptoms were low-grade fatigue (12.5%), headache (10.0%), motor weakness (6.2%), seizure (5.8%), and dizziness (5.4%). The rate of pathologically confirmed radionecrosis at 12 months was 3.6% (95% CI 2.0%-5.8%), and only target volume was associated on multivariate analysis (subdistribution hazard ratio 1.13, 95% CI 1.0-1.20).
conclusionsTo the best of our knowledge, this is the first reported series of proton SRS for the management of brain metastases. Moderate-dose proton SRS is well tolerated and can achieve good local control outcomes, comparable to those obtained with conventional photon SRS strategies. Although proton SRS remains resource-intensive, future strategies evaluating its selective utility in patients who would benefit most from integral dose reduction should be explored.
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