{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:40:35Z","timestamp":1780472435894,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T00:00:00Z","timestamp":1715126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Brainstem metastases (BSM) present a significant neuro\u2010oncological challenge, resulting in profound neurological deficits and poor survival outcomes. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) offer promising therapeutic avenues for BSM despite their precarious location. This international multicenter study investigates the efficacy and safety of SRS and FSRT in 136 patients with 144 BSM treated at nine institutions from 2005 to 2022. The median radiographic and clinical follow\u2010up periods were 6.8 and 9.4\u2009months, respectively. Predominantly, patients with BSM were managed with SRS (69.4%). The median prescription dose and isodose line for SRS were 18\u2009Gy and 65%, respectively, while for FSRT, the median prescription dose was 21\u2009Gy with a median isodose line of 70%. The 12\u2010, 24\u2010, and 36\u2010month local control (LC) rates were 82.9%, 71.4%, and 61.2%, respectively. Corresponding overall survival rates at these time points were 61.1%, 34.7%, and 19.3%. In the multivariable Cox regression analysis for LC, only the minimum biologically effective dose was significantly associated with LC, favoring higher doses for improved control (in Gy, hazard ratio [HR]: 0.86, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). Regarding overall survival, good performance status (Karnofsky performance status, \u226590%; HR: 0.43, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) and prior whole brain radiotherapy (HR: 2.52, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) emerged as associated factors. In 14 BSM (9.7%), treatment\u2010related adverse events were noted, with a total of five (3.4%) radiation necrosis. SRS and FSRT for BSM exhibit efficacy and safety, making them suitable treatment options for affected patients.<\/jats:p>","DOI":"10.1002\/ijc.34980","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T04:54:34Z","timestamp":1715230474000},"page":"916-924","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Stereotactic radiosurgery and radiotherapy for brainstem metastases: An international multicenter analysis"],"prefix":"10.1002","volume":"155","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6177-1755","authenticated-orcid":false,"given":"Felix","family":"Ehret","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"German Cancer Consortium (DKTK), partner site Berlin, a partnership 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