{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:35:58Z","timestamp":1788928558054,"version":"build-2803163510"},"reference-count":42,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T00:00:00Z","timestamp":1757116800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thegreenjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Radiotherapy and Oncology"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.radonc.2025.111128","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T12:26:55Z","timestamp":1757334415000},"page":"111128","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"special_numbering":"C","title":["Intraoperative radiotherapy for resectable brain metastases: a systematic review and meta-analysis"],"prefix":"10.1016","volume":"212","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4527-4024","authenticated-orcid":false,"given":"Cas Stefaan","family":"Dejonckheere","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6025-7479","authenticated-orcid":false,"given":"Matthias","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5710-6557","authenticated-orcid":false,"given":"Anna-Laura","family":"Potthoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4828-7496","authenticated-orcid":false,"given":"Motaz","family":"Hamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Scafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2919-8622","authenticated-orcid":false,"given":"Thomas","family":"Zeyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5642-9062","authenticated-orcid":false,"given":"Lea L.","family":"Friker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molina","family":"Grimmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Kugel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3430-4590","authenticated-orcid":false,"given":"Stephan","family":"Garbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Radbruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut","family":"Vatter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5243-4781","authenticated-orcid":false,"given":"Frank Anton","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Herrlinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Gkika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5929-7270","authenticated-orcid":false,"given":"Gustavo Renato","family":"Sarria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7692-7775","authenticated-orcid":false,"given":"Julian Philipp","family":"Layer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.radonc.2025.111128_b0005","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1007\/s11912-011-0203-y","article-title":"Epidemiology of brain metastases","volume":"14","author":"Nayak","year":"2012","journal-title":"Curr Oncol Rep"},{"key":"10.1016\/j.radonc.2025.111128_b0010","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1200\/JCO.21.02314","article-title":"Treatment for brain metastases: ASCO-SNO-ASTRO guideline","volume":"40","author":"Vogelbaum","year":"2022","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0015","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1001\/jama.280.17.1485","article-title":"Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial","volume":"280","author":"Patchell","year":"1998","journal-title":"J Am Med Assoc"},{"key":"10.1016\/j.radonc.2025.111128_b0020","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ijrobp.2021.04.016","article-title":"Stereotactic radiosurgery for postoperative metastatic surgical cavities: a critical review and international stereotactic radiosurgery society (ISRS) practice guidelines","volume":"111","author":"Redmond","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2025.111128_b0025","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/S1470-2045(17)30441-2","article-title":"Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C\/CEC.3): a multicentre, randomised, controlled, phase 3 trial","volume":"18","author":"Brown","year":"2017","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0030","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.3390\/curroncol30020101","article-title":"Five-fraction stereotactic radiotherapy for brain metastases-a retrospective analysis","volume":"30","author":"Layer","year":"2023","journal-title":"Curr Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0035","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2018.00395","article-title":"Diagnosis and management of radiation necrosis in patients with brain metastases","volume":"8","author":"Vellayappan","year":"2018","journal-title":"Front Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0040","article-title":"Boswellia serrata for the management of radiation-induced cerebral Edema and necrosis: a systematic meta-narrative review of clinical evidence","volume":"101732","author":"Dejonckheere","year":"2025","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0045","first-page":"133","article-title":"Optimal timing of radiotherapy following brain metastases surgery","volume":"9","author":"Yaghi","year":"2022","journal-title":"Neurooncol Pract"},{"key":"10.1016\/j.radonc.2025.111128_b0050","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2021.768168","article-title":"Intraoperative radiotherapy in brain malignancies: indications and outcomes in primary and metastatic brain tumors","volume":"11","author":"Cifarelli","year":"2021","journal-title":"Front Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0055","article-title":"Treatment protocols and outcomes of intraoperative radiotherapy for brain metastases: a systematic review","volume":"5","author":"Pascual","year":"2021","journal-title":"Eur J Med Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0060","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s11060-019-03309-6","article-title":"Intraoperative radiotherapy (IORT) for surgically resected brain metastases: outcome analysis of an international cooperative study","volume":"145","author":"Cifarelli","year":"2019","journal-title":"J Neurooncol"},{"key":"10.1016\/j.radonc.2025.111128_b0065","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.radonc.2025.111128_b0070","doi-asserted-by":"crossref","DOI":"10.3390\/cancers14061515","article-title":"Benchmarking safety indicators of surgical treatment of brain metastases combined with intraoperative radiotherapy: results of prospective observational study with comparative matched-pair analysis","volume":"14","author":"Hamed","year":"2022","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.radonc.2025.111128_b0075","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1007\/s11060-023-04464-7","article-title":"Intraoperative or postoperative stereotactic radiotherapy for brain metastases: time to systemic treatment onset and other patient-relevant outcomes","volume":"164","author":"Dejonckheere","year":"2023","journal-title":"J Neurooncol"},{"key":"10.1016\/j.radonc.2025.111128_b0080","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2018.00074","article-title":"Intraoperative radiotherapy with INTRABEAM: technical and dosimetric considerations","volume":"8","author":"Sethi","year":"2018","journal-title":"Front Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0085","doi-asserted-by":"crossref","unstructured":"Diehl CD et al. Opportunities and alternatives of modern radiation oncology and surgery for the management of resectable brain metastases. Cancers vol. 15 Preprint at https:\/\/doi.org\/10.3390\/cancers15143670 (2023).","DOI":"10.3390\/cancers15143670"},{"key":"10.1016\/j.radonc.2025.111128_b0090","doi-asserted-by":"crossref","first-page":"v89","DOI":"10.1093\/neuonc\/noae144.298","article-title":"P17.11.B interim analysis of a phase II trial of intraoperative radiotherapy (IORT) with INTRABEAM after SURGICAL RESECTION OF BRAIN METASTases (BM) (NCT05084092)","volume":"26","author":"Maci\u00e0 i Garau","year":"2024","journal-title":"Neuro Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0095","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1200\/JCO.2023.41.16_suppl.2031","article-title":"INTRAMET: results of a prospective, single-arm, open-label phase II trial of intraoperative radiotherapy after resection of brain metastases","volume":"41","author":"Brehmer","year":"2023","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0100","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/S1470-2045(17)30414-X","article-title":"Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-centre, randomised, controlled, phase 3 trial","volume":"18","author":"Mahajan","year":"2017","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0105","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1001\/jamaoncol.2020.4630","article-title":"Multi-institutional analysis of prognostic factors and outcomes after hypofractionated stereotactic radiotherapy to the resection cavity in patients with brain metastases","volume":"6","author":"Eitz","year":"2020","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0110","article-title":"Preoperative stereotactic radiosurgery for patients with 1-4 brain metastases: a single-arm phase 2 trial outcome analysis (NCT03398694)","volume":"11","author":"Agrawal","year":"2024","journal-title":"Neurooncol Pract"},{"key":"10.1016\/j.radonc.2025.111128_b0115","article-title":"Surgical cavity constriction and local progression between resection and adjuvant radiosurgery for brain metastases","volume":"8","author":"Shah","year":"2016","journal-title":"Cureus"},{"key":"10.1016\/j.radonc.2025.111128_b0120","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2017.00147","article-title":"Immunotherapy combined with large fractions of radiotherapy: stereotactic radiosurgery for brain metastases-implications for intraoperative radiotherapy after resection","volume":"7","author":"Herskind","year":"2017","journal-title":"Front Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0125","doi-asserted-by":"crossref","first-page":"3657","DOI":"10.1007\/s10143-022-01838-9","article-title":"Intraoperative radiotherapy during awake craniotomies: preliminary results of a single-center case series","volume":"45","author":"Steininger","year":"2022","journal-title":"Neurosurg Rev"},{"key":"10.1016\/j.radonc.2025.111128_b0130","doi-asserted-by":"crossref","DOI":"10.1007\/s00066-024-02239-1","article-title":"Intraoperative radiation therapy for brain metastasis in a pregnant patient: a case report","volume":"200","author":"Aninditha","year":"2024","journal-title":"Strahlenther Onkol"},{"key":"10.1016\/j.radonc.2025.111128_b0135","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s11060-023-04443-y","article-title":"Intracranial intraoperative radiotherapy (IORT): evaluation of electrocorticography and peri-operative seizure risk","volume":"164","author":"Cifarelli","year":"2023","journal-title":"J Neurooncol"},{"key":"10.1016\/j.radonc.2025.111128_b0140","doi-asserted-by":"crossref","DOI":"10.1007\/s10143-025-03523-z","article-title":"Resection with intraoperative radiotherapy vs. adjuvant radiotherapy in the treatment of eloquent brain metastases: an analysis of feasibility and safety","volume":"48","author":"Krauss","year":"2025","journal-title":"Neurosurg Rev"},{"key":"10.1016\/j.radonc.2025.111128_b0145","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2020.586029","article-title":"Efficacy of BRAF inhibitors in combination with stereotactic radiosurgery for the treatment of melanoma brain metastases: a systematic review and meta-analysis","volume":"10","author":"Khan","year":"2021","journal-title":"Front Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0150","article-title":"Intraoperative radiotherapy in brain metastasis surgery allows faster transition to systemic therapy","author":"Krauss","year":"2025","journal-title":"Neurooncol Pract"},{"key":"10.1016\/j.radonc.2025.111128_b0155","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s11060-020-03657-8","article-title":"Type and timing of systemic therapy use predict overall survival for patients with brain metastases treated with radiation therapy","volume":"151","author":"Fan","year":"2021","journal-title":"J Neurooncol"},{"key":"10.1016\/j.radonc.2025.111128_b0160","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijrobp.2024.01.009","article-title":"Multicentric assessment of safety and efficacy of combinatorial adjuvant brain metastasis treatment by intraoperative radiation therapy and immunotherapy","author":"Layer","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2025.111128_b0165","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s00066-018-1387-y","article-title":"Cavity volume changes after surgery of a brain metastasis-consequences for stereotactic radiation therapy","volume":"195","author":"Scharl","year":"2019","journal-title":"Strahlenther Onkol"},{"key":"10.1016\/j.radonc.2025.111128_b0170","article-title":"Impact of postoperative changes in brain anatomy on target volume delineation for high-grade glioma","volume":"1\u201311","author":"Dejonckheere","year":"2023","journal-title":"D"},{"key":"10.1016\/j.radonc.2025.111128_b0175","article-title":"Image guided intraoperative radiation therapy after surgical resection of brain metastases: a first in-human feasibility report","volume":"9","author":"Grimmer","year":"2024","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.radonc.2025.111128_b0180","doi-asserted-by":"crossref","first-page":"825","DOI":"10.3171\/2014.11.JNS1449","article-title":"Intraoperative radiotherapy to treat newly diagnosed solitary brain metastasis: initial experience and long-term outcomes","volume":"122","author":"Weil","year":"2015","journal-title":"J Neurosurg"},{"key":"10.1016\/j.radonc.2025.111128_b0185","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s11060-018-2968-4","article-title":"Feasibility of dose escalation using intraoperative radiotherapy following resection of large brain metastases compared to post-operative stereotactic radiosurgery","volume":"140","author":"Vargo","year":"2018","journal-title":"J Neurooncol"},{"key":"10.1016\/j.radonc.2025.111128_b0190","doi-asserted-by":"crossref","first-page":"e104","DOI":"10.1016\/j.ijrobp.2023.06.876","article-title":"A phase II trial of intraoperative radiotherapy after surgical resection of brain metastases: feasibility and efficacy NCT04847284","volume":"117","author":"Foro","year":"2023","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2025.111128_b0195","doi-asserted-by":"crossref","DOI":"10.3390\/cancers15010014","article-title":"Low-energy X-Ray intraoperative radiation therapy (Lex-IORT) for resected brain metastases: a single-institution experience","volume":"15","author":"Diehl","year":"2022","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.radonc.2025.111128_b0200","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s11060-023-04266-x","article-title":"Intraoperative radiotherapy for brain metastases: first-stage results of a single-arm, open-label, phase 2 trial","volume":"162","author":"de Castro","year":"2023","journal-title":"J Neurooncol"},{"key":"10.1016\/j.radonc.2025.111128_b0205","doi-asserted-by":"crossref","DOI":"10.1007\/s11060-023-04380-w","article-title":"Outcome assessment of intraoperative radiotherapy for brain metastases: results of a prospective observational study with comparative matched-pair analysis","author":"Layer","year":"2023","journal-title":"J Neurooncol"},{"key":"10.1016\/j.radonc.2025.111128_b0210","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s11060-024-04691-6","article-title":"Intraoperative radiotherapy after neurosurgical resection of brain metastases as institutional standard treatment- update of the oncological outcome form a single center cohort after 117 procedures","volume":"169","author":"Kahl","year":"2024","journal-title":"J Neurooncol"}],"container-title":["Radiotherapy and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167814025046328?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167814025046328?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T04:21:14Z","timestamp":1780114874000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0167814025046328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":42,"alternative-id":["S0167814025046328"],"URL":"https:\/\/doi.org\/10.1016\/j.radonc.2025.111128","relation":{},"ISSN":["0167-8140"],"issn-type":[{"value":"0167-8140","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Intraoperative radiotherapy for resectable brain metastases: a systematic review and meta-analysis","name":"articletitle","label":"Article Title"},{"value":"Radiotherapy and Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.radonc.2025.111128","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"111128"}}