Evidence map›Paper›PMID 40914931›Full record

ArticleJournal of neuro-oncology2025

Repeat stereotactic radiosurgery for treatment of brain metastases locally recurrent following initial radiosurgery.

Jennifer C Hall, Keshav Goel, Yulia Lozko, Steven D Chang, David J Park, Yusuke S Hori, Fred C Lam, Deyaldeen AbuReesh, Scott Jackson, Gordon Li and 9 more

Abstract read
PubMed Publisher
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. Outcomes in long-term survivors treated with stereotactic cranial radiotherapy for brain metastases.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
    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

19 authors.

Jennifer C Hall *Department of Radiation Oncology, Stanford University, Stanford, CA, USA.
Keshav Goel *Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Yulia LozkoDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
Steven D ChangDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.
David J ParkDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.
Yusuke S HoriDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.
Fred C LamDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.
Deyaldeen AbuReeshDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.
Scott JacksonDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
Gordon LiDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.
Melanie Hayden-GephartDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.
Taryn KanekoDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
Seema NagpalDepartment of Neurology, Stanford University, Stanford, CA, USA.
Iris C GibbsDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
Elham RahimyDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
John ByunDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
Katherine JinDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
Erqi PollomDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
Scott G SoltysDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA. sgsoltys@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe report outcomes of repeat stereotactic radiosurgery (rSRS) to sites of tumor progression following initial SRS. Additionally, we sought to determine if, at the time of recurrence following initial SRS, surgical resection of the tumor followed by SRS (surgery + rSRS) provided benefit compared to rSRS alone.

methodsWe retrospectively reviewed patients treated with rSRS for local recurrence after initial SRS. The cumulative incidences of LF and adverse radiation effect (ARE), with death as a competing risk, were estimated.

resultsFrom 2004 to 2022, we identified 77 patients with 429 brain metastases treated with initial SRS, of which 97 metastases were treated with rSRS for salvage of LF following initial SRS; 49 metastases had resection prior to rSRS. Of the 429 brain metastases treated with initial SRS, the cumulative incidence of LF was 12.6% [95% confidence interval (CI) 9.7-15.9] at 1 year; in 97 sites treated with rSRS, LF was 14.6% (95%CI 8.4-22.4) at 1 year. There was no significant difference (p = 0.3) in 1-year LF after surgery + rSRS [11.1% (95%CI 4.0-22.31)] versus rSRS alone [18.4% (95%CI 9.0-30.5)]. The 1-year rates of ARE were: 3.0% (95%CI 1.7-5.0%) for initial SRS (overall grade 1-4), 15.6% (95%CI 9.2-23.6) for rSRS (overall grade 1-4), and 12.6% (95%CI 6.8-20.1%) for rSRS (symptomatic grade 2-4).

conclusionGiven that the 1-year local progression of 15% with rSRS is similar to the 13% of initial SRS, our data do not support that tumors recurrent after initial SRS are inherently radioresistant to salvage SRS. Tumor control must be balanced by the 1-year rates of adverse radiation effect (16% overall, 13% symptomatic).

Indexed as

Brain NeoplasmsNeoplasm Recurrence, LocalRadiosurgeryAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedReoperationRetrospective StudiesSalvage TherapyBrain metastasesMultipleRadiosurgeryRecurrentRepeat

Identifiers

PMID40914931

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.