Evidence map›Paper›PMID 41663549›Full record

ArticleJournal of neuro-oncology2026

Symptomatic radiation necrosis after concurrent targeted therapy and stereotactic radiosurgery for brain metastases: a bicentric retrospective analysis.

Ethan M Steele, Jacob T Hall, Kevin Lui, Rami Darawsheh, John W Shumway, Lisa A Carey, Katherine E Reeder-Hayes, Carrie B Lee, Stergios J Moschos, Frances A Collichio and 14 more

Abstract readMulticenter Study
PubMed 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. 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

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

24 authors.

Ethan M SteeleDepartment of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, 27514, USA.
Jacob T HallVirginia Oncology Associates, Norfolk, VA, USA.
Kevin LuiDepartment of Radiation Oncology, University of Cincinnati, Cincinnati, OH, USA.
Rami DarawshehUniversity of California San Francisco School of Medicine, San Francisco, CA, USA.
John W ShumwayDepartment of Radiation Oncology, El Camino Hospital, Mountain View, CA, USA.
Lisa A CareyDivision of Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Katherine E Reeder-HayesDivision of Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Carrie B LeeDivision of Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Stergios J MoschosDivision of Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Frances A CollichioDivision of Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Soma SenguptaDepartment of Neurology, Tufts Medical Center, Boston, MA, USA.
Dominique M HigginsDepartment of Neurosurgery, University of North Carolina, Chapel Hill, NC, USA.
Rekha T ChaudharyDivision of Oncology, Department of Medicine, University of Cincinnati, Cincinnati, OH, USA.
Lalanthica V YogendranDepartment of Neurology, University of Cincinnati, Cincinnati, OH, USA.
Timothy D StruveDepartment of Radiation Oncology, University of Cincinnati, Cincinnati, OH, USA.
Ralph E VatnerKettering Health Cancer Care, Kettering, OH, USA.
Luke E PaterDepartment of Radiation Oncology, University of Cincinnati, Cincinnati, OH, USA.
John C BrenemanDepartment of Radiation Oncology, University of Cincinnati, Cincinnati, OH, USA.
Norberto O AndaluzDepartment of Neurosurgery, University of Cincinnati, Cincinnati, OH, USA.
Jonathan A ForbesDepartment of Neurosurgery, University of Cincinnati, Cincinnati, OH, USA.
Gaorav P GuptaDepartment of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, 27514, USA.
Ashley A WeinerDepartment of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, 27514, USA.
Kyle WangDepartment of Radiation Oncology, University of Cincinnati, Cincinnati, OH, USA.
Colette J ShenDepartment of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, 27514, USA. colette_shen@med.unc.edu.ORCID http://orcid.org/0000-0002-3855-7360

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

PURPOSE/OBJECTIVE(S): Data describing the safety/efficacy of targeted therapies in combination with stereotactic radiotherapy (SRS/SRT) for brain metastases are limited. We leverage a bicentric cohort to evaluate rates of intracranial failure and radiation necrosis in patients receiving targeted therapy and SRS. MATERIALS/

methodsPatients with intact brain metastases at two institutions treated with SRS/SRT and concurrent central nervous system (CNS)-active targeted therapy were identified. Concurrent targeted therapy was defined as receipt of targeted therapy starting before and continuing through receipt of radiation therapy, except for a brief washout interval of 3–7 days. Patients were followed for a minimum of 3 months after SRS/SRT with brain MRI. Kaplan-Meier analysis was performed to evaluate overall survival and cumulative rates of symptomatic radiation necrosis (sRN). Variables associated with radiation necrosis on univariable analysis (p < 0.2) were included in a multivariable logistic regression model for adjusted analysis.

resultsThe study included 93 patients with 306 metastases, and median follow-up was 17 months. The overall rate of sRN per-metastasis and per-patient was 16/306 (5%) and 13/93 (13%), respectively. Symptomatic RN occurred in 6/28 (21%) of patients exposed to anti-HER2 agents overall and in 3/15 (20%) of those exposed to anti-HER2 antibody-drug conjugate agents (ADCs). Anti-HER2 demonstrated a trend toward significance (p = 0.107) and met the threshold for inclusion in the multivariable analysis. On adjusted analysis, exposure to anti-HER2 therapy was associated with increased odds of sRN, but this was non-significant (odds ratio 2.49, 95% CI[0.66–9.41], p = 0.180). Median overall survival for the cohort was 27.4 months with median intracranial progression-free survival of 12 months.

conclusionsPatients treated with a combination of SRS/SRT and targeted therapy demonstrated a median of 12 months of intracranial control with limited radiation necrosis.

Indexed as

Brain NeoplasmsMolecular Targeted TherapyRadiation InjuriesRadiosurgeryAdultAgedAged, 80 and overCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedNecrosisPrognosisRetrospective StudiesAntibody-drug conjugatesAnti-HER2 therapyRadiation necrosisRadiosurgerySRSTargeted therapyToxicity

Identifiers

PMID41663549

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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.