Evidence map›Paper›PMID 41563519›Full record

ArticleJournal of neuro-oncology2026

Clinical outcomes of three-fraction versus five-fraction stereotactic radiosurgery for resected brain metastases.

Giuseppe Minniti, Paolo Tini, Piera Navarria, Giorgio Raza, Giuseppe Maria Della Pepa, Silvia Chiesa, Francesca De Felice, Lucy Zaccaro, Luca Capone, Miriam Tomaciello and 6 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Review
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

16 authors.

Giuseppe MinnitiDepartment of Radiological Sciences, Oncology, and Anatomical Pathology, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, Rome, 00161, Italy. giuseppe.minniti@uniroma1.it.
Paolo TiniDepartment of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
Piera NavarriaRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, 20089, Italy.
Giorgio RazaUPMC Hillman Cancer Center, San Pietro Hospital FBF, Rome, Italy.
Giuseppe Maria Della PepaDepartment of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, Rome, 00168, Italy.
Silvia ChiesaDepartment of Radiology, Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Francesca De FeliceDepartment of Radiological Sciences, Oncology, and Anatomical Pathology, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, Rome, 00161, Italy.
Lucy ZaccaroDepartment of Radiological Sciences, Oncology, and Anatomical Pathology, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, Rome, 00161, Italy.
Luca CaponeUPMC Hillman Cancer Center, San Pietro Hospital FBF, Rome, Italy.
Miriam TomacielloDepartment of Radiological Sciences, Oncology, and Anatomical Pathology, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, Rome, 00161, Italy.
Gaetano LanzettaIRCCS Neuromed, Pozzilli (IS), Italy.
Martina GiraffaUPMC Hillman Cancer Center, San Pietro Hospital FBF, Rome, Italy.
Ivana RussoUPMC Hillman Cancer Center, Villa Maria, Mirabella Eclano (AV), Italy.
Francesco MaramponDepartment of Radiological Sciences, Oncology, and Anatomical Pathology, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, Rome, 00161, Italy.
Antonio BrunoIRCCS Neuromed, Pozzilli (IS), Italy.
Sergio PaoliniIRCCS Neuromed, Pozzilli (IS), Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate the clinical outcomes of patients with brain metastases undergoing surgery followed by postoperative three-fraction or five-fraction radiosurgery (SRS) to the resection cavity. Factors associated with local failure and symptomatic radionecrosis were evaluated. PATIENTS AND

methodsOne hundred and ninety consecutive patients with 202 brain metastases who received surgery followed by three- or five-fraction SRS to the surgical bed were analyzed. All cavities included in the study received either 27 Gy in 3 fractions or 30 Gy in 5 fractions given daily on consecutive days. Cumulative incidence analysis was used to compare local control and symptomatic radionecrosis between groups from the time of SRS.

resultsTen cavities after 3-fraction and 14 lesions after 5-fraction SRS group recurred (p = 0.38) with a median time to progression of 12 months. Cumulative LC rates were 93% (87–97) and 90.2% (87.5–94.5) at 1 year, and 90% (84–96) and 85.5% (76.2–91.3) at 2 years (p = 0.4) for 3-fraction and 5-fraction SRS groups, respectively. Symptomatic radionecrosis developed in 28 patients (3-fraction SRS,16; 5-fraction SRS,12), requiring surgery or medical treatment; the 1-year and 2-year cumulative rates were 12.8% (8.3–22.4%) and 17.9% (12.3–28.9%), respectively, after 3-fraction SRS, and 9.8% (6.5–19.1%) and 13.0% (7.3–22.2%), respectively, after 5-fraction SRS (p = 0.3). Sixteen patients after 3-fraction and fourteen patients after 5-fraction SRS developed leptomeningeal disease (LMD); 1-year LMD cumulative rates were 13.5% and 13.8%.

conclusionsBoth 3 × 9 Gy and 5 × 6 Gy are effective SRS treatment modalities for resected brain metastases associated with high local control and low risk of symptomatic radionecrosis.

Indexed as

Brain NeoplasmsRadiosurgeryAdultAgedAged, 80 and overDose Fractionation, RadiationFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm Recurrence, LocalRadiation InjuriesRetrospective StudiesTreatment OutcomeBrain metastasesHypofractionated stereotactic radiosurgeryLeptomeningeal diseaseRadiation necrosisResection cavity

Identifiers

PMID41563519
PMCPMC12823750

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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.