ReviewCancers2023
Novel Mechanisms and Future Opportunities for the Management of Radiation Necrosis in Patients Treated for Brain Metastases in the Era of Immunotherapy.
Review in Cancers, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Magnetic resonance spectroscopy (MRS) for differentiating tumour recurrence from radiation necrosis in treated intra-axial brain tumours.The Cochrane database of systematic reviews · 2026Pooled it
- Impact of Radionecrosis and Local Recurrence on Overall Survival After Stereotactic Radiosurgery for Brain Metastases.Advances in radiation oncology · 2026Article
- Incidence of radiation necrosis following different radiotherapy fractionation schedules for intracranial meningiomas.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Reassessing the Management of Treatment-Induced Brain Necrosis in Metastatic Patients: Advancing Surgical Alternatives to Steroid Therapy.Neurosurgery practice · 2025Review
- Radiation Necrosis in Neuro-Oncology: Diagnostic Complexity and Precision Radiotherapy Strategies.Cancers · 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
- Bevacizumab for symptomatic cerebral radiation necrosis after radiation of high-grade glioma or brain metastases - when and for whom?Neuro-oncology practice · 2025Review
- Value of artificial intelligence in neuro-oncology.The Lancet. Digital health · 2025Review
- 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
- Article
- Seizure risk factors and management approaches in patients with brain metastases.Neuro-oncology practice · 2025Review
- Radiogenomic explainable AI with neural ordinary differential equation for identifying post-SRS brain metastasis radionecrosis.Medical physics · 2025Article
- Decoding Patient Heterogeneity Influencing Radiation-Induced Brain Necrosis.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024Article
- Dose-Incorporated Deep Ensemble Learning for Improving Brain Metastasis Stereotactic Radiosurgery Outcome Prediction.International journal of radiation oncology, biology, physics · 2024Article
- Article
- Tumoral Interferon Beta Induces an Immune-Stimulatory Phenotype in Tumor-Associated Macrophages in Melanoma Brain Metastases.Cancer research communications · 2024Article
- Long-Term Intracranial Outcomes With Combination Dual Immune-Checkpoint Blockade and Stereotactic Radiosurgery in Patients With Melanoma and Non-Small Cell Lung Cancer Brain Metastases.International journal of radiation oncology, biology, physics · 2024Article
- Current state and promise of user-centered design to harness explainable AI in clinical decision-support systems for patients with CNS tumors.Frontiers in radiology · 2024Review
- Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report.Oncology letters · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
Radiation necrosis, also known as treatment-induced necrosis, has emerged as an important adverse effect following stereotactic radiotherapy (SRS) for brain metastases. The improved survival of patients with brain metastases and increased use of combined systemic therapy and SRS have contributed to a growing incidence of necrosis. The cyclic GMP-AMP (cGAMP) synthase (cGAS) and stimulator of interferon genes (STING) pathway (cGAS-STING) represents a key biological mechanism linking radiation-induced DNA damage to pro-inflammatory effects and innate immunity. By recognizing cytosolic double-stranded DNA, cGAS induces a signaling cascade that results in the upregulation of type 1 interferons and dendritic cell activation. This pathway could play a key role in the pathogenesis of necrosis and provides attractive targets for therapeutic development. Immunotherapy and other novel systemic agents may potentiate activation of cGAS-STING signaling following radiotherapy and increase necrosis risk. Advancements in dosimetric strategies, novel imaging modalities, artificial intelligence, and circulating biomarkers could improve the management of necrosis. This review provides new insights into the pathophysiology of necrosis and synthesizes our current understanding regarding the diagnosis, risk factors, and management options of necrosis while highlighting novel avenues for discovery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.