Evidence map›Paper›PMID 40085175›Full record

ArticleActa neurochirurgica2025

Leukoencephalopathy following stereotactic radiosurgery for breast cancer brain metastases: a single-center analysis of 1,077 lesions.

Salem M Tos, Bardia Hajikarimloo, Georgios Mantziaris, Mariam Ishaque, Purushotham Ramanathan, David Schlesinger, Jason P Sheehan

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Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Salem M TosDepartment of Neurosurgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
Bardia HajikarimlooDepartment of Neurosurgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
Georgios MantziarisDepartment of Neurosurgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
Mariam IshaqueDepartment of Neurosurgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
Purushotham RamanathanDepartment of Neurosurgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
David SchlesingerDepartment of Radiation Oncology, University of Virginia, Charlottesville, VA, USA.
Jason P SheehanDepartment of Neurosurgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA. jsheehan@virginia.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeukoencephalopathy is the most prevalent and delayed adverse radiation effect (ARE) after intracranial radiotherapy (RT). Patients with leukoencephalopathy experience some levels of cognitive and neurological dysfunction. This investigation assessed the frequency and clinical outcomes of leukoencephalopathy following stereotactic radiosurgery (SRS) alone or SRS following whole-brain radiation therapy (WBRT) in breast cancer brain metastasis.

methodsWe retrospectively evaluated the data of brain metastases from breast cancer individuals who underwent SRS between 2007 and 2022. MRI sequences were examined to assess white matter changes and tumor control.

resultsAmong 125 patients with 1,077 brain metastases, 58 (46.4%) patients received WBRT prior to SRS. By year 3, 23.4% of WBRT + SRS patients developed high-grade leukoencephalopathy (grades 2-3) compared to 5.7% in the SRS-only group (p < 0.001). In univariate analyses, significant predictors of high-grade leukoencephalopathy included prior WBRT (HR: 18.4, p = 0.005), cumulative integral dose > 3 J (HR: 4.17, p = 0.029), and the total number of lesions (HR: 1.22, p < 0.001). In multivariate analyses, prior WBRT (HR: 11.1, p = 0.022) and total lesions (HR: 1.14, p = 0.037) remained significant predictors.

conclusionOur findings demonstrated that WBRT plus SRS is associated with higher leukoencephalopathy rates than SRS alone. This underscores the importance of carefully weighing the benefits and risks of different ionizing radiation approaches in the management of brain metastasis from breast cancer.

Indexed as

Brain NeoplasmsBreast NeoplasmsCranial IrradiationLeukoencephalopathiesRadiosurgeryAdultAgedFemaleHumansMagnetic Resonance ImagingMiddle AgedRetrospective StudiesTreatment OutcomeBrain metastasisBreast cancerLeukoencephalopathyRadiosurgery

Identifiers

PMID40085175
PMCPMC11909051

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