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Radiologic and clinical outcomes after SRS were determined and prognostic factors identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At SRS, median patient age was 55 years [interquartile range (IQR) 47.6\u201362.0], and 156 (80%) patients had KPS\u2009\u2265\u200980. The median tumor volume was 0.1 cm\n                      <jats:sup>3<\/jats:sup>\n                      (IQR 0.1\u20130.5) and the median prescription dose was 16\u00a0Gy (IQR 16\u201318). Local tumor control (LTC) rate was 98%, 94%, 93%, 90%, and 88% at six-, 12-, 24-, 36- and 60-months post-SRS, respectively. On multivariate analysis, tumor volume (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009&lt;\u20090.001) and concurrent pertuzumab (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) improved LTC. Overall survival (OS) rates at six-, 12-, 24-, 36-, 48-, and 60-months were 90%, 69%, 46%, 27%, 22%, and 18%, respectively. Concurrent pertuzumab improved OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032). In this patient subgroup, GPA scores\u2009\u2265\u20092.5 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and rare primary tumor histologies (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) were associated with increased and decreased OS, respectively. Asymptomatic adverse radiation events (ARE) occurred in 27 (14.0%) and symptomatic ARE in five (2.6%) patients. Invasive lobular carcinoma primary (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042) and concurrent pertuzumab (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) conferred an increased risk for overall but not for symptomatic ARE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SRS affords effective LTC for selected patients with BM from HER-2 positive breast cancer. Concurrent pertuzumab improved LTC and OS but at the same time increased the risk for overall, but not symptomatic, ARE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-024-04775-3","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T12:02:33Z","timestamp":1724760153000},"page":"199-208","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Stereotactic radiosurgery for brain metastases from human epidermal receptor 2 positive breast Cancer: an international, multi-center study"],"prefix":"10.1007","volume":"170","author":[{"given":"Stylianos","family":"Pikis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Mantziaris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Protopapa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salem M.","family":"Tos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman O.","family":"Kowalchuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Blake","family":"Ross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad G.","family":"Rusthoven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjul","family":"Tripathi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Marie","family":"Langlois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mathieu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Chia","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huai-che","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selcuk","family":"Peker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yavuz","family":"Samanci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Yu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve E.","family":"Braunstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhishuo","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Niranjan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dade L.","family":"Lunsford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Sheehan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,27]]},"reference":[{"key":"4775_CR1","doi-asserted-by":"publisher","first-page":"4834","DOI":"10.1158\/1078-0432.CCR-10-2962","volume":"17","author":"AM Brufsky","year":"2011","unstructured":"Brufsky AM, Mayer M, Rugo HS et al (2011) Central nervous system metastases in patients with HER2-positive metastatic breast cancer: incidence, treatment, and survival in patients from registHER. 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