ArticleRadiation oncology (London, England)2023
Stereotactic radiosurgery of brain metastases: a retrospective study.
Article in Radiation oncology (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The clinical outcomes of combined stereotactic radiosurgery with PD-1/PD-L1 inhibitors in patients with metastatic brain tumors: a systematic review and meta-analysis on the safety and efficacy.Neurosurgical review · 2025Pooled it
- Up to Four-Year Outcomes of Single-Fraction Stereotactic Radiosurgery for Small Brain Metastases: A Competing-Risk Analysis.Cancer medicine · 2026Article
- Integrated nomogram for predicting intracranial progression-free survival with EGFR-TKI combined with cranial radiotherapy: a multicenter study.European radiology · 2026Article
- Radionecrosis risk and local control after CyberKnifeRadiation oncology (London, England) · 2026Article
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- Silent Threat: Delayed Brain Metastasis After Successful Ovarian Cancer Therapy.Clinical case reports · 2025Article
- Effect of gamma knife dose rate and tumor-specific factors on treatment outcomes in brain metastases: insights from a cohort study.Journal of cancer research and clinical oncology · 2025Article
- Evaluation of the efficacy and safety of HyperArc stereotactic radiotherapy for the treatment of lung cancer brain metastasis.Medical oncology (Northwood, London, England) · 2025Article
- Article
- Outcomes of stereotactic radiosurgery for pituitary metastases: an international multi-institutional study.Pituitary · 2025Article
- HER2-Positive Breast Cancer-Current Treatment Management and New Therapeutic Methods for Brain Metastasis.Biomedicines · 2025Review
- Stereotactic Radiosurgery for Intracranial Breast Metastases: A Systematic Review and Meta-Analysis.Cancers · 2024Review
- Advancements in Imaging and Neurosurgical Techniques for Brain Tumor Resection: A Comprehensive Review.Cureus · 2024Review
- Alectinib continuation beyond progression inTranslational lung cancer research · 2024Article
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4 authors.
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Abstract
backgroundSingle-fraction stereotactic radiosurgery (SRS) is an established standard for radiation therapy of brain metastases although recent developments indicate that multi-fractionated stereotactic radiotherapy (FSRT) results in lower radiation necrosis especially for larger metastases, and the same or even better local control in comparison to SRS.
methodsSeventy-two patients with 111 brain metastases received SRS with a single dose of 18 Gy between September 2014 and December 2021. The dose prescription was either 18 Gy given to the enclosing 80% isodose with a normalization to Dmax = 100% of 22.5 Gy (part I) or 18 Gy = D98, while D0.03 cc of 21.6-22.5 Gy was accepted (part II). The study retrospectively evaluated local progression-free survival (LPFS), response on the first follow-up magnetic resonance imaging (MRI), and radiation necrosis.
resultsMelanoma brain metastases (n = 44) were the most frequent metastases. The median gross tumor volume (GTV) was 0.30 cm³ (IQR, 0.17-0.61). The median follow-up time of all patients was 50.8 months (IQR, 30.4-64.6). Median LPFS was 23.5 months (95%CI 17.2, 29.8). The overall LPFS rates at 12-, 18-, 24- and 30 months were 65.3%, 56.3%, 46.5%, and 38.8%. Brain metastases with radioresistant histology (melanoma, renal cell cancer, and sarcoma) showed a 12-month LPFS of 60.2%, whereas brain metastases with other histology had a 12-month LPFS of 70.1%. The response of brain metastases on first follow-up MRIs performed after a median time of 47 days (IQR, 40-63) was crucial for long-term local control and survival. Eight brain metastases (7.2%) developed radiation necrosis after a median time of 18.4 months (IQR, 9.4-26.5). In multivariate analyses, a GTV > 0.3 cm³ negatively affected LPFS (HR 2.229, 95%CI 1.172, 4.239). Melanoma, renal cell cancers, and sarcoma had a lower chance of LPFS in comparison to other cancer types (HR 2.330, 95%CI 1.155, 4.699).
conclusionsOur results indicate a reasonable 1-year local control of brain metastases with radiosensitive histology. Radioresistant metastases show a comparatively poor local control. Treatment refinements merit exploration to improve local control of brain metastases.
trial registrationThis study is retrospectively registered (ethics approval number 23-3451-104).
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