ArticleJournal of neuro-oncology2025
Paradigm shift in patients with multiple brain metastases from whole brain radiotherapy to high precision multimodality treatment including stereotactic radiotherapy.
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.
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Who cites it
1 citing paper in PubMed.
- Stereotactic radiotherapy in brain metastases: SRS/FSRT paradox and preferences of radiation oncologists in Türkiye (TROD 10-010 study).Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
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13 authors.
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Abstract
backgroundWhole brain radiotherapy (WBRT) is increasingly being replaced by high precision multimodality treatment including stereotactic radiotherapy (SRT) in patients with ≥ 4 brain metastases (BMs). The implications of this trend on survival rates are uncertain. Our study examines the time trends for survival rates of patients treated with radiotherapy for brain metastases during this era of shifting treatment paradigms.
methodsPatients with newly diagnosed BMs treated with SRT or WBRT between 2010 and 2023 were included, regardless of the number of brain metastases or the primary malignancy. Patients were excluded if they had previously undergone cranial radiotherapy. Differences in survival between treatment years were evaluated using Log-rank tests. A P value of ≤ 0.05 (two-sided) was considered statistically significant.
resultsA total of 1106 patients were included for analysis. Of these, 832 (75%) were treated with SRT, while 274 (25%) were treated with WBRT. The median number of BMs was 2 (IQR 1-5), while 367 (33%) patients had ≥ 4 BMs. The proportion of patients with ≥ 4 BMs who were treated with linear accelerator-based SRT instead of WBRT increased over time: 2010-2014: 9 (11%); 2015-2019: 52 (31%); 2020-2023: 80 (68%). An improvement in survival rates of patients with ≥ 4 BMs was observed over time (median survival 2010-2014: 5 months; 2015-2019: 6 months; 2020-2023: 7 months, P < 0.001).
conclusionIn patients treated for multiple (≥ 4) BMs, survival increased when radiotherapy modality shifted from WBRT to high precision multimodality treatment including SRT, resection, and systemic therapy.
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