ArticleNeuro-oncology practice2020
Predictors of radiation necrosis in long-term survivors after Gamma Knife stereotactic radiosurgery for brain metastases.
Article in Neuro-oncology practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 20 citations in OpenAlex.
- Article
- Bevacizumab for symptomatic cerebral radiation necrosis after radiation of high-grade glioma or brain metastases - when and for whom?Neuro-oncology practice · 2025Review
- Management outcomes for biopsy-proven radiation necrosis in patients with brain metastases in the era of immune-checkpoint blockade.Journal of neuro-oncology · 2025Article
- Effectiveness of Gamma Knife radiosurgery for recurrent glioblastoma: a 10-year retrospective analysis.Neurosurgical review · 2025Article
- Leveraging radiomics and machine learning to differentiate radiation necrosis from recurrence in patients with brain metastases.Journal of neuro-oncology · 2024Article
- Assessment of Radiation Dosage to the Hippocampi during Treatment of Multiple Brain Metastases Using Gamma Knife Therapy.Medicina (Kaunas, Lithuania) · 2024Article
- Article
- Whole brain radiation therapy resulting in radionecrosis: a possible link with radiosensitising chemoimmunotherapy.BMJ case reports · 2023Article
- Review
- Long-Term Survival after Linac-Based Stereotactic Radiosurgery and Radiotherapy with a Micro-Multileaf Collimator for Brain Metastasis.Current oncology (Toronto, Ont.) · 2022Article
- Clinical implementation of HyperArc.Physical and engineering sciences in medicine · 2022Article
- Radiation Necrosis from Stereotactic Radiosurgery-How Do We Mitigate?Current treatment options in oncology · 2021Review
- Stereotactic radiosurgery and ipilimumab for patients with melanoma brain metastases: clinical outcomes and toxicity.Journal of neuro-oncology · 2018Article
- Optimization of Normal Tissue Objectives (NTO) in HyperArc Radiosurgery for Brain Oligometastases: A Systematic Analysis of the Trade-Offs among Dosimetric Quality, Plan Complexity, and Treatment Efficiency.Technology in cancer research & treatmentArticle
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe long-term risk of necrosis after radiosurgery for brain metastases is uncertain. We aimed to investigate incidence and predictors of radiation necrosis for individuals with more than 1 year of survival after radiosurgery for brain metastases.
methodsPatients who had a diagnosis of brain metastases treated between December 2006 and December 2014, who had at least 1 year of survival after first radiosurgery were retrospectively reviewed. Survival was analyzed using the Kaplan-Meier estimator, and the incidence of radiation necrosis was estimated with death or surgical resection as competing risks. Patient and treatment factors associated with radiation necrosis were also analyzed.
resultsA total of 198 patients with 732 lesions were analyzed. Thirty-four lesions required salvage radiosurgery and 10 required salvage surgical resection. Median follow-up was 24 months. The estimated median survival for this population was 25.4 months. The estimated per-lesion incidence of radiation necrosis at 4 years was 6.8%. Medical or surgical therapy was required for 60% of necrosis events. Tumor volume and male sex were significant factors associated with radiation necrosis. The per-lesions incidence of necrosis for patients undergoing repeat radiosurgery was 33.3% at 4 years.
conclusionsIn this large series of patients undergoing radiosurgery for brain metastases, patients continued to be at risk for radiation necrosis throughout their first 4 years of survival. Repeat radiosurgery of recurrent lesions greatly exacerbates the risk of radiation necrosis, whereas treatment of larger target volumes increases the risk modestly.
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