Trial reportJAMA2026
Treatment for Brain Metastases With Stereotactic Radiation vs Hippocampal-Avoidance Whole Brain Radiation: A Randomized Clinical Trial.
Trial report in JAMA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03075072 (Hippocampal Sparing Whole Brain Radiation Versus Stereotactic Radiation), which is not on this map. Cited by 13 papers.
What it found
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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.
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.
Hippocampal Sparing Whole Brain Radiation Versus Stereotactic Radiation (SRS) in Patients With 5-20 Brain Metastases: A Phase III, Randomized Clinical Trial
Who cites it
13 citing papers in PubMed.
- Memory circuit dosimetry in patients with brain metastases treated with Sparing Memory with Advanced Radiosurgery Targeting (SMART) technique.Clinical and translational radiation oncology · 2026Article
- Predictive modeling of lung cancer subtype with integration of clinical and thoracic imaging features to guide early brain metastasis management.Journal of neuro-oncology · 2026Article
- The evolution of RTOG and NRG Oncology CNS tumors clinical trials.Journal of neuro-oncology · 2026Review
- Postoperative fractionated stereotactic radiotherapy for completely resected brain metastases with 25 Gy in five fractions: A single-center retrospective study.Clinical and translational radiation oncology · 2026Article
- RAPid simPLE (RAPPLE) Targeted Radiation Treatment Versus Whole Brain Radiation Therapy: A Retrospective Cohort Study of Matched Patients With Brain Metastases and Poor Prognosis.Advances in radiation oncology · 2026Article
- Radiation treatment patterns for breast cancer brain metastases: an NCDB analysis.Breast cancer research and treatment · 2026Article
- Article
- Stereotactic radiotherapy for brain metastases: indications, dose fractionation, technological innovations, and evolving combination strategies - a comprehensive review.Frontiers in oncology · 2026Review
- Treatment of oligometastatic lung cancers: new data, new drivers, new approaches.BMJ oncology · 2026Review
- Management of brain metastases in older adults with non-small cell lung cancer.Frontiers in oncology · 2026Review
- Stereotactic versus hippocampal avoidance whole-brain radiotherapy combined with immune checkpoint inhibitors for multiple brain metastases in non-small cell lung cancer: a multi-center retrospective study.Frontiers in oncology · 2026Article
- Efficacy and safety of brain radiotherapy combined with antibody-drug conjugates in patients with HER2-positive breast cancer brain metastases.Frontiers in oncology · 2026Article
- Linac-based stereotactic radiosurgery for brain metastases: Survival and salvage treatment in a contemporary cohort of 3893 patients.Neuro-oncology advancesArticle
Corrections and comments
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Brain metastases are common in patients with cancer, and radiation is often used for management. Among patients with more than 4 brain metastases, the effects of stereotactic radiation targeting only individual tumors, compared with whole brain radiation with hippocampal avoidance, which radiates both tumors and normal brain, remain unknown. Objective: To determine whether stereotactic radiation improves symptom severity and interference with daily functioning, compared with whole brain radiation with hippocampal avoidance. Design, Setting, and Participants: Phase 3, open-label, randomized clinical trial conducted at 4 United States-based centers. Eligible patients had 5 to 20 brain metastases and no prior brain-directed radiation. Enrollment occurred between April 11, 2017, and May 17, 2024 (final follow-up, March 18, 2025). Intervention: Stereotactic radiation, compared with whole brain radiation with hippocampal avoidance. Main Outcomes and Measures: Mean weighted patient-reported symptom severity and interference score change over 6 months postbaseline relative to baseline using the MD Anderson Symptom Inventory-Brain Tumor instrument (scale, 0-10; score change range, -10 to 10; -10 = best). A clinically meaningful Δ was defined as 0.98. Results: Of 196 randomized patients (mean age, 61 years; 129 [66%] female; 176 [90%] White; median number of brain metastases, 14 [IQR, 11-18]; 49 [25%] with prior neurosurgical resection), 83 (42%) completed the 6-month assessment. For the primary outcome, between baseline and postbaseline assessments through the 6-month follow-up, stereotactic radiation changed the weighted composite MD Anderson Symptom Inventory-Brain Tumor score from 2.69 to 2.37 (mean change, -0.32) and hippocampal-avoidance whole brain radiation changed the score from 2.29 to 3.03 (mean change, 0.74) (mean difference, -1.06 [95% CI, -1.54 to -0.58]; P < .001). Related grade 3-5 adverse events occurred in 12 patients (12%) in the stereotactic radiation group and 13 patients (13%) in the hippocampal-avoidance whole brain radiation group; grade 1-3 fatigue was most frequent (27 [28%] vs 43 [44%], respectively). Conclusions and Relevance: In patients with 5 to 20 brain metastases, these findings support stereotactic radiation over hippocampal-avoidance whole brain radiation to improve symptoms and interference with daily functioning, key components of quality of life. Trial Registration: ClinicalTrials.gov Identifier: NCT03075072.
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