ArticleJournal of neuro-oncology2026
Reduced dose single-fraction frame-based postoperative radiosurgery for large (> 10 cm
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.
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Abstract
BACKGROUND/
aimAt our institution, large resection cavities (LRC) of brain metastases (BRM) are typically treated with reduced dose (RD), single-fraction (SF) frame-based (FB) postoperative stereotactic radiosurgery (PSR). We aimed to determine the impact of this management practice on efficacy and safety outcomes.
methodsThis retrospective analysis examined 50 consecutive patients whose BRM-associated LRCs (> 10 cm3) were treated with SF FB PSR between October 2000 and October 2021. The prescription dose of < 18 Gy for the large tumor beds was applied in 41 patients, and 18 Gy was administered in nine. The frequencies of local tumor control and radionecrosis were the primary endpoints of the study, and survival was the secondary measure of treatment.
resultsThe median follow-up was 12 months. Comparative analysis of the applied lower versus higher dose revealed: local tumor control rates of 88% (95% CI 83%-93%) and 100% (95% CI 96%–104%) respectively, p > 0.64; corresponding incidences of radionecrosis were 0% and 11% (95% CI 0%-22%), p > 0.38, and the median periods of survival were 8 months and 19 months (p > 0.05). In the 25 individuals with at least 12 months of follow-up, the local tumor control and radionecrosis rates were 84% (n-21) and 4% (n = 1), respectively. In the proven case of radionecrosis without observed tumor cells, the V12 Gy normal brain volume was 21.7 cm3.
conclusionWe believe that SF RD PSR can be considered a rational treatment strategy for patients with LRC-BRM due to the observed favorable tumor control and minimal toxicity.
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