ArticleNeuro-oncology2019
Outcomes following stereotactic radiosurgery for small to medium-sized brain metastases are exceptionally dependent upon tumor size and prescribed dose.
Article in Neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 46 citations in OpenAlex.
- Stereotactic Radiosurgery for Thalamic Brain Metastases: A Retrospective Analysis and Literature Review.Neurosurgery practice · 2026Article
- Reduced dose single-fraction frame-based postoperative radiosurgery for large (> 10 cmJournal of neuro-oncology · 2026Article
- Article
- Evaluating the detection of small brain lesions in magnetic resonance using deep learning.Frontiers in neuroscience · 2026Article
- Prognostic factors, patterns of failure and re-irradiation in hypofractionated stereotactic radiotherapy-treated brain metastases from non-small cell lung cancer.Clinical and translational radiation oncology · 2025Article
- Impact of brain metastasis size at the time of radiotherapy on local control and radiation necrosis.Journal of neuro-oncology · 2025Article
- Multidisciplinary management strategies for recurrent brain metastasis after prior radiotherapy: An overview.Neuro-oncology · 2025Review
- Brain metastases from lung cancer: recent advances and novel therapeutic opportunities.Discover oncology · 2025Review
- Genomic predictors of radiation response: recent progress towards personalized radiotherapy for brain metastases.Cell death discovery · 2024Review
- Article
- Response of treatment-naive brain metastases to stereotactic radiosurgery.Nature communications · 2024Article
- Rate of pachymeningeal failure following adjuvant WBRT vs SRS in patients with brain metastases.Clinical and translational radiation oncology · 2024Article
- Toxicity and outcomes of melanoma brain metastases treated with stereotactic radiosurgery: the risk of subsequent symptomatic intralesional hemorrhage exceeds that of radiation necrosis.Journal of neuro-oncology · 2023Article
- Sensitizing brain metastases to stereotactic radiosurgery using hyperbaric oxygen: A proof-of-principle study.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2022Article
- Factors correlating with survival following adjuvant or definitive radiosurgery for large brain metastases.Neuro-oncology · 2022Article
- Gamma knife icon based hypofractionated stereotactic radiosurgery (GKI-HSRS) for brain metastases: impact of dose and volume.Journal of neuro-oncology · 2022Article
- Multimodality MRI-based radiomics approach to predict the posttreatment response of lung cancer brain metastases to gamma knife radiosurgery.European radiology · 2022Article
- Outcomes of Hypofractionated Stereotactic Radiotherapy for Small and Moderate-Sized Brain Metastases: A Single-Institution Analysis.Frontiers in oncology · 2022Article
- Brain metastases: An update on the multi-disciplinary approach of clinical management.Neuro-Chirurgie · 2022Review
- Article
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Authors and funding
16 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAt our institution, we have historically treated brain metastasis (BM) ≤2 cm in eloquent brain with a radiosurgery (SRS) lower prescription dose (PD) to reduce the risk of radionecrosis (RN). We sought to evaluate the impact of this practice on outcomes.
methodsWe analyzed a prospective registry of BM patients treated with SRS between 2008 and 2017. Incidences of local failure (LF) and RN were determined and Cox regression was performed for univariate and multivariate analyses (MVAs).
resultsWe evaluated 1533 BM ≤2 cm. Median radiographic follow-up post SRS was 12.7 months (1.4-100). Overall, the 2-year incidence of LF was lower for BM treated with PD ≥21 Gy (9.3%) compared with PD ≤15 Gy (19.5%) (sub-hazard ratio, 2.3; 95% CI: 1.4-3.7; P = 0.0006). The 2-year incidence of RN was not significantly higher for the group treated with PD ≥21 Gy (9.5%) compared with the PD ≤15 Gy group (7.5%) (P = 0.16). MVA demonstrated that PD (≤15 Gy) and tumor size (>1 cm) were significantly correlated (P < 0.05) with higher rates of LF and RN, respectively. For tumors ≤1 cm, when comparing PD ≤15 Gy with ≥21 Gy, the risks of LF and RN are equivalent. However, for lesions >1 cm, PD ≥21 Gy is associated with a lower incidence of LF without significantly increasing the risk of RN.
conclusionOur results indicate that rates of LF or RN following SRS for BM are strongly correlated with size and PD. Based on our results, we now, depending upon the clinical context, consider increasing PD to 21 Gy for BM in eloquent brain, excluding the brainstem.
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