Evidence map›Paper›PMID 42479234›Full record

ArticleJournal of neuro-oncology2026

Frameless stereotactic radiosurgery in the management of brain metastases: long-term oncologic and toxicity outcomes.

Swati Kinger, Geoffrey Sedor, Elizabeth J Buss, Eric Giannaris, Jacqueline Testaiuti, Brian J A Gill, Brett E Youngerman, Raymond F Sekula, Guy M McKhann, Michael B Sisti and 4 more

Abstract read
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

14 authors.

Swati KingerColumbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Geoffrey SedorDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA.
Elizabeth J BussDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA.
Eric GiannarisCUNY School of Medicine, New York, NY, USA.
Jacqueline TestaiutiDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA.
Brian J A GillDepartment of Neurological Surgery, Columbia University Irving Medical Center, New York, NY, USA.
Brett E YoungermanDepartment of Neurological Surgery, Columbia University Irving Medical Center, New York, NY, USA.
Raymond F SekulaDepartment of Neurological Surgery, Columbia University Irving Medical Center, New York, NY, USA.
Guy M McKhannDepartment of Neurological Surgery, Columbia University Irving Medical Center, New York, NY, USA.
Michael B SistiDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA.
Jeffrey N BruceDepartment of Neurological Surgery, Columbia University Irving Medical Center, New York, NY, USA.
Simon K ChengDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA.
Tony J C WangDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA. tjw2117@cumc.columbia.edu.
Matthew GallittoDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA. mg4249@cumc.columbia.edu.

Funding

The Brief Research in Aging and Interdisciplinary NeurosciencesT35AG044303 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Sachin Agarwal, Jennifer Jaie Manly · 2013 to 2026
$1.9M
NIA NIH HHS T35AG044303
6 · The paper itself

Abstract

objectiveGamma Knife radiosurgery (GKRS) is a widely accepted treatment modality for brain metastases and has historically relied on pin-based frame fixation, with a frameless option introduced in recent years. Previous studies suggest similar local control and overall survival between frameless and frame-based GKRS, but data on long-term outcomes remain limited. In this study, we sought to evaluate outcomes of single-fraction frameless GKRS for patients treated at our institution between 2018 and 2024.

methodsWe retrospectively reviewed the medical records of patients treated with single-fraction frameless GKRS for brain metastases. Patient characteristics, treatment parameters, local control, freedom from distant recurrence, and overall survival were evaluated, as well as toxicity outcomes such as radiation necrosis and new-onset seizures.

resultsOur cohort included 140 patients with a total of 362 brain metastases. Primary tumor types included non-small cell lung (32%), breast (21%), melanoma (16%), and gastrointestinal (9%). Median marginal dose was 20 Gy, with mean target volume of 0.14 cc (0.04-0.56). Median clinical follow-up time was 2.4 years. At 1- and 2-years post-treatment, local control was 98% (95% CI, 96%-100%) and 97% (95% CI, 94%-99%), respectively. Median overall survival was 2.5 years (95% CI, 1.992-4.271). One patient (0.7%) had symptomatic radiation necrosis following treatment.

conclusionsIn this single-institutional experience, frameless GKRS demonstrated excellent oncologic outcomes, adding to the growing body of literature that frameless-based radiosurgical techniques do not compromise locoregional control. To our knowledge, this is the largest single-institution frameless GKRS cohort reported to date.

Indexed as

Brain NeoplasmsRadiosurgeryAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeBrain metastasesFrameless techniqueGamma Knife radiosurgeryStereotactic radiosurgery

Identifiers

PMID42479234

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.