Evidence map›Paper›PMID 40361483›Full record

ArticleCancers2025

Patterns of Recurrence After Postoperative Stereotactic Radiotherapy for Brain Metastases.

Jeroen A Crouzen, Anna L Petoukhova, Martijn Hakstege, Elise E M W van Schaik, Rishi D S Nandoe Tewarie, Rob J A Nabuurs, Maaike J Vos, Melissa Kerkhof, Thijs van der Vaart, Johan A F Koekkoek and 8 more

Abstract read
In one paragraph

Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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.

Jeroen A CrouzenDepartment of Radiation Oncology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.ORCID 0000-0002-2869-4812
Anna L PetoukhovaDepartment of Medical Physics, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.ORCID 0000-0003-4617-0622
Martijn HakstegeDepartment of Radiation Oncology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.ORCID 0009-0001-7117-0459
Elise E M W van SchaikDepartment of Radiation Oncology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.ORCID 0009-0001-7397-2113
Rishi D S Nandoe TewarieDepartment of Neurosurgery, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.ORCID 0000-0003-1697-8428
Rob J A NabuursDepartment of Neurosurgery, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
Maaike J VosDepartment of Neurology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
Melissa KerkhofDepartment of Neurology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.ORCID 0000-0002-1875-9387
Thijs van der VaartDepartment of Neurology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.ORCID 0000-0002-3858-4027
Johan A F KoekkoekDepartment of Neurology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Rogier E HagenbeekDepartment of Radiology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
Fatih M YildirimDepartment of Radiology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
Lisette M WiltinkDepartment of Radiotherapy, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.ORCID 0000-0003-3483-4241
Noëlle C M G van der Voort van ZypDepartment of Radiation Oncology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
Mandy KiderlenDepartment of Radiation Oncology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
Marike L D BroekmanDepartment of Neurosurgery, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
Mirjam E MastDepartment of Radiation Oncology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
Jaap D ZindlerDepartment of Radiation Oncology, Haaglanden Medical Center, Lijnbaan 32, 2512 VA The Hague, The Netherlands.ORCID 0000-0002-3084-4568

Funding

Jacobusstichting The Hague N/A
6 · The paper itself

Abstract

BACKGROUND/

objectivesNeurosurgical resection is the standard treatment for large brain metastases (BMs). Postoperative stereotactic radiotherapy (SRT) is used to reduce local recurrence (LR) but does not always prevent leptomeningeal disease (LMD). This study aims to analyze patterns of tumor recurrence and to identify opportunities for the further improvement of treatment efficacy.

methodsWe included 147 patients who underwent resection and SRT for BMs. The distance between the resection cavity target volume and the new tumor growth was calculated. Cox regression analyses were used to assess associations of LMD with various patient characteristics.

resultsMedian survival after postoperative SRT was 14 months (IQR 6-30) with a 3-year actuarial survival rate of 21%. LR occurred in 20/147 patients (14%). After total resection, LR occurred in 21% of patients after 3 years of follow-up compared to 36% after subtotal resection. Marginal LR occurred in 5/147 patients (3%). LMD was found in 21/147 patients (14%; 3-year actuarial rate, 26%), and it was found more commonly in patients with resected cerebellar metastases (23%; 3-year actuarial rate, 46%) compared to those with cerebral metastases (11%; 3-year actuarial rate 17%) (HR 2.54, 95% CI 1.07-6.04,

conclusionsThis study examined patterns of recurrence after postoperative radiotherapy and its implications for radiation dose, radiation field size, and treatment sequence. Local control was high after total resection. Radiation field size appeared adequate given the low incidence of marginal recurrences. Patients with cerebellar metastases showed an increased risk of LMD, underscoring the need for preventive measures, particularly preoperative SRT.

Indexed as

brain metastasesmeningeal carcinomatosisneurosurgeryradiosurgery

Identifiers

PMID40361483
PMCPMC12071874

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Registered trials

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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.