Preoperative Stereotactic Radiosurgery for Brain Metastases: A Phase 1 Dose Escalation Study Demonstrating Reduced Leptomeningeal Disease.

ABSTRACT:

Purpose

Preoperative stereotactic radiosurgery (SRS) has been proposed as a strategy to reduce nodular leptomeningeal disease (nLMD) after resection of brain metastases by devitalizing tumor cells before surgical manipulation. This study aimed to determine the safety of preoperative SRS via a phase 1 dose escalation trial and compare outcomes-including nLMD, classical LMD, local control, and overall survival (OS)-between preoperative and postoperative treatment cohorts.

Methods and materials

A phase 1 trial evaluated the safety of single-fraction preoperative SRS at escalating doses (12 and 15 Gy) in patients with tumors 2 to 6 cm. Adverse events were assessed per National Cancer Institute Common Terminology Criteria for Adverse Events v4.0, with dose-limiting toxicity (DLT)

SUBMITTER: Hoyle JM 

PROVIDER: S-EPMC12546788 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature