Evidence map›Paper›PMID 40827321›Full record

ArticleJournal of Korean medical science2025

Fractionated Gamma Knife Radiosurgery as a Primary Treatment for Large Brain Metastases.

Ho Sung Myeong, Hye Ran Park, Sang Soon Jeong, Jung Hoon Kim, Jae Meen Lee, Kwang Hyon Park, Kawngwoo Park, Hyun Joo Park, Byung Woo Yoon, Eun Jung Lee and 4 more

Abstract read
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In one paragraph

Article in Journal of Korean medical science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Ho Sung MyeongDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0002-5970-1704
Hye Ran ParkDepartment of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0003-0506-4882
Sang Soon JeongDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0002-8566-0117
Jung Hoon KimDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0002-8090-7758
Jae Meen LeeDepartment of Neurosurgery and Biomedical Research Institute, Pusan National University Hospital and School of Medicine, Pusan National University, Busan, Korea.ORCID https://orcid.org/0000-0002-5708-1644
Kwang Hyon ParkDepartment of Neurosurgery, Chungnam National University Sejong Hospital, Sejong, Korea.ORCID https://orcid.org/0000-0003-2386-4680
Kawngwoo ParkDepartment of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.ORCID https://orcid.org/0000-0002-6568-1009
Hyun Joo ParkDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0003-4481-6637
Byung Woo YoonDepartment of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.ORCID https://orcid.org/0000-0003-1391-6344
Eun Jung LeeDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0002-7011-0569
Jin Wook KimDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0002-1338-1928
Hyun Tai ChungDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0001-8243-2568
Dong Gyu KimDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0003-2904-7331
Sun Ha PaekDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0003-3007-8653

Funding

Electronics and Telecommunications Research Institute 21YB1500Korea Research Institute of Bioscience and Biotechnology KGM456212109816National Research Foundation of Korea 2015M3C7A1028926National Research Foundation of Korea 2020M3A9G8022029National Research Foundation of Korea NRF2017M3C7A1047392
6 · The paper itself

Abstract

backgroundTo assess the effectiveness of fractionated Gamma Knife radiosurgery (fGKS) as a primary treatment for newly diagnosed large (> 10 cm³) brain metastases.

methodsNinety-three patients with newly diagnosed large brain metastases, comprising 99 lesions, who underwent fGKS were included in this retrospective study. Tumor and edema volumes were measured using follow-up magnetic resonance imaging for longitudinal analysis. Local or distant progression-free survival (PFS) rate in the brain, and overall survival (OS) rates were analyzed. Cox regression analysis was used to assess prognostic factors for local progression. Radiation toxicity was evaluated based on RTOG CNS toxicity grades.

resultsMedian local PFS was 15.5 months, distant PFS was 13.2 months, overall PFS was 8.2 months, and OS was 15.2 months. Both tumor and edema volumes were significantly reduced by 78% and 82%, respectively, over 6-9 months after fGKS. Tumor volume decreased by ≥ 50% in 80.8% (n = 80) of lesions, with a median maximal reduction time of 3.3 months. Radiation necrosis occurred in 5.4% (n = 5) of patients. Within 6 months after fGKS, 45 patients showed neurological improvement, 36 remained stable, and 12 experienced neurological worsening. Systemic therapy was a significant prognostic factor for local PFS.

conclusionfGKS could be recommended as an effective and safe primary treatment for large brain metastases.

Indexed as

Brain NeoplasmsRadiosurgeryAdultAgedAged, 80 and overDose Fractionation, RadiationFemaleHumansKaplan-Meier EstimateMagnetic Resonance ImagingMaleMiddle AgedPrognosisProgression-Free SurvivalProportional Hazards ModelsRetrospective StudiesFractionated Gamma Knife Radiosurgery (fGKS)Large Brain MetastasesPrimary TreatmentProgression-Free Survival

Identifiers

PMID40827321
PMCPMC12360905

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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.