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Intracavitary radiotherapy techniques\u2014namely intraoperative radiotherapy (IORT) and brachytherapy (IBT)\u2014have gained attention as alternatives to stereotactic radiotherapy, potentially reducing neurotoxicity and treatment delays. However, robust comparative data remain scarce.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We performed a systematic meta-analysis including both conventional and reconstructed individual patient data (IPD) from studies reporting outcomes after intracavitary radiotherapy post-BM resection. Primary endpoint was local control rate (LCR); secondary endpoints included overall survival (OS), distant brain control (DBC), radiation necrosis (RN), and leptomeningeal disease (LMD). IPD was reconstructed from published Kaplan-Meier curves. Survival and incidence outcomes were pooled using random-effects models in R.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Twenty-three studies with 858 patients were analyzed. The 1-year LCR was 96% (95% CI: 94\u201398%) for IORT and 95% (95% CI: 92\u201397%) for IBT. Median OS in patients who underwent IORT was 39.1 months (95% CI: 22.0\u201359.5), and 15.9 months (95% CI: 12.6\u201319.9) in whose who underwent IBT, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.004; HR 0.64). IORT was associated with lower RN (4% vs. 7%) and LMD (6% vs. 9%). The 1-year DBC rate was higher for IORT (57%) than IBT (48%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Intracavitary radiotherapy yields excellent local control after BM resection. This IPD meta-analysis provides the most comprehensive evidence to date and supports further prospective evaluation of IORT in neuro-oncological care.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s11060-025-05227-2","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T13:53:30Z","timestamp":1758117210000},"page":"907-919","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intra-cavitary radiotherapy for surgically resected brain metastases: a comprehensive analysis including an individual patient data meta-analysis of intraoperative radiotherapy (IORT) and brachytherapy (IBT)"],"prefix":"10.1007","volume":"175","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8319-0847","authenticated-orcid":false,"given":"Alexandru","family":"Guranda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5243-4781","authenticated-orcid":false,"given":"Erdem","family":"G\u00fcresir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arne Mathias","family":"Ruder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4680-0412","authenticated-orcid":false,"given":"Frank Anton","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Wach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"5227_CR1","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.1093\/neuonc\/nox077","volume":"19","author":"DN Cagney","year":"2017","unstructured":"Cagney DN, Martin AM, Catalano PJ, Redig AJ, Lin NU, Lee EQ, Wen PY, Dunn IF, Bi WL, Weiss SE, Haas-Kogan DA, Alexander BM, Aizer AA (2017) Incidence and prognosis of patients with brain metastases at diagnosis of systemic malignancy: a population-based study. 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