ArticleJournal of radiation research2026
LINAC-based single-isocenter stereotactic radiotherapy for multiple brain metastases.
Article in Journal of radiation research, 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
Advances in chemotherapy and radiotherapy have expanded indications for stereotactic radiosurgery/radiotherapy (SRS/SRT) for multiple brain metastases. We introduced the Elements Multiple Brain Mets System (mSRS/SRT system), using the dynamic conformal arc method with a single isocenter, for treatment of multiple brain metastases with SRS/SRT (mSRS/SRT). This study analyzed outcomes of mSRS/SRT. From December 2018 to March 2023, 29 patients (130 lesions) were treated using the mSRS/SRT system. The prescribed dose for the planning target volume, determined by D95%, was 21 or 18 Gy in a single fraction for a tumor diameter ≤2 cm and 27 Gy in 3 fractions or 35 Gy in 5 fractions for a tumor diameter >2 cm. Median follow-up time was 7.2 months. The 12-month overall survival rate was 48.5%, and systemic therapy after mSRS/SRT was associated with better overall survival. The 12-month lesion-based local recurrence rate was 14.4%, and larger tumor diameter was associated with poorer local control, whereas systemic therapy after mSRS/SRT was associated with better local control. The 12-month intracranial control rate was 43.6%, and non-lung primary tumors, a greater number of lesions, and systemic therapy before mSRS/SRT were associated with poorer intracranial control. Acute adverse events included 4 cases of Grade 1 headache, one of Grade 1 nausea, and one of Grade 2 alopecia. Brain necrosis was observed in 9 patients (13 lesions), and all cases were asymptomatic. These results suggest that the mSRS/SRT system may become a treatment option for multiple brain metastases, although further evaluation is needed.
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