ArticleJournal of neuro-oncology2018
Surgical resection and postoperative radiosurgery versus staged radiosurgery for large brain metastases.
Article in Journal of neuro-oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Liquid biopsy-based genomic risk score to predict neurologic death in non-small cell lung cancer patients.Journal of neuro-oncology · 2026Article
- Neoadjuvant stereotactic radiosurgery for brain metastases: A systematic review and meta-analysis.Neuro-oncology practice · 2026Article
- Breast Cancer Brain Metastases: A Neurosurgical Point of View From a Single-Center Experience.Cureus · 2025Article
- Efficacy and safety of combined anti-vascular and two-staged stereotactic radiosurgery therapy for brain metastases with brainstem compression: a retrospective multicenter study.Clinical & experimental metastasis · 2025Article
- Comparative evaluation of outcomes amongst different radiosurgery management paradigms for patients with large brain metastasis.Journal of neuro-oncology · 2024Article
- Brain Metastasis in the Emergency Department: Epidemiology, Presentation, Investigations, and Management.Cancers · 2024Review
- Multi-institutional study of 'Sandwich treatment' for motor area large brain metastases (LBM) with diameter over 3 cm.Radiology and oncology · 2024Article
- 'Sandwich treatment' for posterior fossa brain metastases with volume larger than 4cmClinical & experimental metastasis · 2023Article
- Review
- Let's make size not matter: tumor control and toxicity outcomes of hypofractionated Gamma Knife radiosurgery for large brain metastases.Journal of neuro-oncology · 2023Article
- The Clinical Frailty Scale as useful tool in patients with brain metastases.Journal of neuro-oncology · 2022Article
- Local control outcomes for combination of stereotactic radiosurgery and immunotherapy for non-small cell lung cancer brain metastases.Journal of neuro-oncology · 2022Article
- Evaluation of Biological Effective Dose in Gamma Knife Staged Stereotactic Radiosurgery for Large Brain Metastases.Frontiers in oncology · 2022Article
- Article
- Multidisciplinary treatment of primary intracranial yolk sac tumor: A case report and literature review.Medicine · 2021Review
- Article
- Comparison of two-stage Gamma Knife radiosurgery outcomes for large brain metastases among primary cancers.Journal of neuro-oncology · 2020Article
- Two-staged stereotactic radiosurgery for the treatment of large brain metastases: Single institution experience and review of literature.Journal of radiosurgery and SBRT · 2020Article
- Impact of brain metastasis velocity on neurologic death for brain metastasis patients experiencing distant brain failure after initial stereotactic radiosurgery.Journal of neuro-oncology · 2020Article
- Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to retrospectively evaluate the new treatment paradigm of staged stereotactic radiosurgery (SRS) for the treatment of large brain metastases (BM) compared to the standard of surgical resection followed by SRS.
methodsWe evaluated 78 patients with large BM treated 2012-2017 with surgical resection and postoperative SRS (surgery + SRS) or staged SRS separated by 1 month. Overall survival (OS) was estimated using the Kaplan Meier method and compared across groups using the log-rank test. Cumulative incidence of neurologic death and local and distant brain failure (LF, DBF) were estimated using competing risk methodology.
resultsForty patients were treated with surgery + SRS and 38 patients were treated with staged SRS. Median follow-up was 23.2 months (95% CI 20.5-39.3). Median OS was 13.2 months for staged SRS compared to surgery + SRS 9.7 months (p = 0.53). Cumulative incidence of neurologic death at 1 year was 23% after surgery + SRS, 27% after staged SRS (p = 0.69); cumulative incidence of LF at 1 year was 6% and 8% (p = 0.65) and 1-year DBF was 59% and 21% (p ≤ 0.01). Overall rates of leptomeningeal failure and radiation necrosis were similar between the groups (p = 0.63 and p = 1.0).
conclusionsThough surgery and postoperative SRS is the standard, staged SRS represents an attractive treatment paradigm for treating large BM without sacrificing LC or survival, and potentially decreases DBF. Prospective studies are needed to validate these findings.
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Registered trials
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