Trial reportNeuro-oncology2025
Hypofractionated stereotactic radiotherapy versus whole-brain radiotherapy following brain metastasis resection: Results of the ESTRON randomized phase 2 trial.
Trial report in Neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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
4 citing papers in PubMed.
- Radiotherapy Modality and Primary Tumor Type as Determinants of Outcomes in Brain Metastases: A Retrospective Study of 734 Patients.Medicina (Kaunas, Lithuania) · 2026Article
- Long-term safety and efficacy of staged stereotactic radiosurgery with Ommaya reservoir aspiration for large cystic brain metastases.Journal of neuro-oncology · 2026Article
- Radionecrosis risk and local control after CyberKnifeRadiation oncology (London, England) · 2026Article
- Clinical outcomes of three-fraction versus five-fraction stereotactic radiosurgery for resected brain metastases.Journal of neuro-oncology · 2026Article
Corrections and comments
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Authors and funding
21 authors.
Funding
Abstract
backgroundPostoperative radiotherapy improves local control after brain metastasis (BM) resection. Whole-brain radiotherapy (WBRT) reduces recurrence risk but impairs neurocognition. Hypofractionated stereotactic radiotherapy of the cavity (HFSRT) may offer equivalent tumor control with reduced toxicity. ESTRON is the first randomized trial comparing post-operative HFSRT and WBRT.
methodsThis single-center phase 2 trial randomized 56 patients with resected BM to receive HFSRT (35 Gy in 7 fractions) or WBRT (30 Gy in 10 fractions). Patients could have ≤ 10 additional unresected BMs. The primary endpoint was intracranial progression-free survival (ic-PFS). Secondary endpoints included local control (LC), overall survival (OS), leptomeningeal disease (LMD), and toxicity.
resultsFifty-four patients were evaluable (n = 27 per arm). At 24.7 months median follow-up, 12-month ic-PFS was 44.4% (HFSRT) versus 59.3% (WBRT) (HR 1.72, P = .080). Median ic-PFS was 4.7 versus 15.0 months. LC at 24 months was 94.1% (HFSRT) versus 85.4% (WBRT) (HR 0.41, P = .433). One-year OS was 63.0% (HFSRT) versus 77.8% (WBRT), with no significant difference in median OS (17.8 vs 27.0 months; HR 1.09, P = .336). One-year risk of LMD was 27.0% (HFSRT, predominantly outside the irradiated field) versus 8.7% (WBRT) (log-rank P = .03). Treatment-related adverse events were more frequent with WBRT (115 vs 54 events), including 19% versus 11% grade 3 events, and poorer neurocognitive performance.
conclusionsSurvival was similar for HFSRT and WBRT, while WBRT trended toward better ic-PFS. HFSRT showed substantially lower toxicity and better neurocognitive preservation, however, a higher risk of LMD. Risks and benefits should be weighed individually when determining post-operative treatment for BM.
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