Evidence map›Paper›PMID 41102486›Full record

ArticleJournal of neuro-oncology2025

Stereotactic radiosurgery for patients with extensive brain metastases across the disease course.

Tina Vaziri, I-Chia Liu, Chetan Bettegowda, Victoria Croog, Christopher Jackson, David Kamson, Lawrence Kleinberg, Carmen Kut, Brandi Page, Debraj Mukherjee and 3 more

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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. An erratum has been issued. 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

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Tina Vaziri *Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA. tvaziri2@jh.edu.
I-Chia Liu *Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Chetan BettegowdaDepartment of Neurosurgery, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Victoria CroogDepartment of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Christopher JacksonDepartment of Neurosurgery, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
David KamsonDepartment of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Lawrence KleinbergDepartment of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Carmen KutDepartment of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Brandi PageDepartment of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Debraj MukherjeeDepartment of Neurosurgery, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Jordina Rincon-TorroellaDepartment of Neurosurgery, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Risheng XuDepartment of Neurosurgery, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Kristin J RedmondDepartment of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA. kjanson3@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeStereotactic radiosurgery (SRS) is the standard of care for patients with limited brain metastases (BM). As systemic therapies prolong survival in metastatic disease, the role of SRS in patients with high intracranial disease burden remains undefined.

methodsNinety patients with ≥15 SRS-treated BMs throughout their disease course between 2010 and 2023 were retrospectively reviewed. Outcomes-including overall survival (OS), freedom from whole-brain radiotherapy (FFW), intracranial control (IC), radiation necrosis (RN), and cumulative brain dose-were analyzed. Outcomes were estimated using the Kaplan-Meier method or Fine-Gray model. Univariable and multivariable regression identified prognostic factors.

resultsThe median number of BMs treated was 18 (IQR, 16-23) over a median of two SRS courses (IQR, 2-3). Primary tumor sites were lung (47.3%) and breast (22.6%). At initial SRS, 84.9% had ECOG ≤1/KPS > 70, and 33% had neurologic symptoms. With median follow-up of 15 months (range, 0-118), RN occurred in 8.9%; 13.3% developed leptomeningeal disease (median onset 12 months) with a higher risk observed in breast cancer (OR 4.20, 95% CI 1.19-14.87, p = 0.026). The mean cumulative whole-brain dose across all SRS courses was 5.3 Gy. One-year FFW was 75.1% and 68.8% did not undergo WBRT. Median OS was 17 months (95% CI 9.46-24.54), with 1-year OS of 64%.

conclusionsSRS is safe and feasible for patients with a high BM burden, offering potential delay and avoidance of WBRT. Prospective, multi-institutional studies are warranted to validate these findings and further define the role of SRS in this population.

Indexed as

Brain NeoplasmsRadiosurgeryAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateBrain metastasisOncologyStereotactic radiosurgery

Identifiers

PMID41102486

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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.