Evidence map›Paper›PMID 40360909›Full record

ArticleJournal of neuro-oncology2025

Development of a recursive partitioning analysis for prediction of radiation necrosis following single-fraction stereotactic radiosurgery for intact brain metastases.

Anirudh Bommireddy, Zachary S Mayo, Chandana A Reddy, Cole Billena, Erik M Davies, Robin W Davis, Erin S Murphy, John H Suh, Ehsan H Balagamwala, Timothy A Chan and 8 more

Abstract read
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In one paragraph

Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Anirudh Bommireddy *Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA. bommira@ccf.org.
Zachary S Mayo *Tennessee Oncology, Nashville, TN, USA.
Chandana A ReddyDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.
Cole BillenaDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.
Erik M DaviesDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.
Robin W DavisDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.
Erin S MurphyDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.
John H SuhDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.
Ehsan H BalagamwalaDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.
Timothy A ChanDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.
Jennifer S YuDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.
Gene H BarnettDeparment of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.
Lilyana AngelovDeparment of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.
Alireza M MohammadiDeparment of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.
Glen H J StevensDepartment of Neuro-Oncology, Cleveland Clinic, Cleveland, OH, USA.
Matthew GrabowskiDeparment of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.
David M PeereboomDepartment of Neuro-Oncology, Cleveland Clinic, Cleveland, OH, USA.
Samuel T ChaoDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

PURPOSE/

objectiveRadiation necrosis (RN) is a potential complication after stereotactic radiosurgery (SRS) for brain metastases. This study develops a recursive partitioning analysis (RPA) to identify patients at risk for RN following SRS.

methodsPatients who underwent single-fraction SRS for intact brain metastases at a single institution from 2017 to 2021 were identified. Cox regression identified factors associated with RN, and variables with p < 0.1 were included in the RPA. Patients with staged SRS, incomplete records, or less than 3 months of follow-up were excluded.

resultsThe study included 170 patients with 919 lesions, with median follow-up of 9 months. Primary disease sites were non-small cell lung cancer (NSCLC, 49%), breast cancer (12%), melanoma (11%), renal cancer (6%), and others (22%). Median prescription dose was 24 Gy, and median maximum lesion dimension (MLD) was 0.7 cm. RN occurred in 110 (12.2%) lesions, of which 32 (3.5%) were symptomatic, at median of 4.9 months after SRS. Variables for RPA included primary disease site, tumor location, MLD, prior SRS, number of SRS targets, dosimetry, prior hemorrhage, and concurrent systemic therapy. RPA identified four groups: Group 1 (MLD ≤ 0.8 cm, non-breast/NSCLC/renal), Group 2 (MLD ≤ 0.8 cm, breast/NSCLC/renal), Group 3 (MLD > 0.8 cm, no post-SRS hemorrhage), and Group 4 (MLD > 0.8 cm, post-SRS hemorrhage). Two-year RN free survival was 99% (Group 1), 89% (Group 2), 70% (Group 3), and 52% (Group 4).

conclusionThis is the first RPA model for RN after single-fraction SRS, which may aid in risk assessment and distinguishing RN from tumor progression.

Indexed as

Brain NeoplasmsRadiation InjuriesRadiosurgeryAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedNecrosisPrognosisRetrospective StudiesBrain metastasisRadiation necrosisRecursive partitioning analysisSRSStereotactic radiosurgery

Identifiers

PMID40360909
PMCPMC12208986

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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.