{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:15:06Z","timestamp":1791648906969,"version":"4.3.4"},"reference-count":46,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2009,3,1]],"date-time":"2009-03-01T00:00:00Z","timestamp":1235865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2009,3,1]],"date-time":"2009-03-01T00:00:00Z","timestamp":1235865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Surgical Neurology"],"published-print":{"date-parts":[[2009,3]]},"DOI":"10.1016\/j.surneu.2007.12.019","type":"journal-article","created":{"date-parts":[[2008,4,19]],"date-time":"2008-04-19T09:18:19Z","timestamp":1208596699000},"page":"280-288","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":35,"title":["Combined surgical resection and stereotactic radiosurgery for treatment of cerebral metastases"],"prefix":"10.1016","volume":"71","author":[{"suffix":"Jr","given":"David D.","family":"Limbrick","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eriks A.","family":"Lusis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Chicoine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith M.","family":"Rich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph G.","family":"Dacey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua L.","family":"Dowling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Grubb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Filiput","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Drzymala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Mansur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph R.","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"2","key":"10.1016\/j.surneu.2007.12.019_bib1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.neulet.2007.03.029","article-title":"Gene expression changes in the rodent hippocampus following whole brain irradiation","volume":"418","author":"Achanta","year":"2007","journal-title":"Neurosci Lett"},{"issue":"1","key":"10.1016\/j.surneu.2007.12.019_bib2","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1093\/jnci\/87.1.34","article-title":"Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases","volume":"87","author":"Alexander","year":"1995","journal-title":"J Natl Cancer Inst"},{"issue":"21","key":"10.1016\/j.surneu.2007.12.019_bib3","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1001\/jama.295.21.2483","article-title":"Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial","volume":"295","author":"Aoyama","year":"2006","journal-title":"JAMA"},{"issue":"1","key":"10.1016\/j.surneu.2007.12.019_bib4","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1023\/B:NERV.0000026649.68781.8e","article-title":"A critical review of the clinical effects of therapeutic irradiation damage to the brain: the roots of controversy","volume":"14","author":"Armstrong","year":"2004","journal-title":"Neuropsychol Rev"},{"issue":"1","key":"10.1016\/j.surneu.2007.12.019_bib5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S0360-3016(96)85008-5","article-title":"A multiinstitutional outcome and prognostic factor analysis of radiosurgery for resectable single brain metastasis","volume":"35","author":"Auchter","year":"1996","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"10.1016\/j.surneu.2007.12.019_bib6","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1081\/CNV-58889","article-title":"Current concepts and controversies in the treatment of parenchymal brain metastases: improved outcomes with aggressive management","volume":"23","author":"Bajaj","year":"2005","journal-title":"Cancer Invest"},{"issue":"5","key":"10.1016\/j.surneu.2007.12.019_bib7","doi-asserted-by":"crossref","first-page":"748","DOI":"10.3171\/jns.1996.84.5.0748","article-title":"Surgery versus radiosurgery in the treatment of brain metastasis","volume":"84","author":"Bindal","year":"1996","journal-title":"J Neurosurg"},{"issue":"6","key":"10.1016\/j.surneu.2007.12.019_bib8","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s11864-006-0026-5","article-title":"Managing the cognitive effects of brain tumor radiation therapy","volume":"7","author":"Butler","year":"2006","journal-title":"Curr Treat Options Oncol"},{"issue":"5","key":"10.1016\/j.surneu.2007.12.019_bib9","first-page":"936","article-title":"Outcome variation among \u201cradioresistant\u201d brain metastases treated with stereotactic radiosurgery","volume":"56","author":"Chang","year":"2005","journal-title":"Neurosurgery"},{"issue":"2","key":"10.1016\/j.surneu.2007.12.019_bib10","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1227\/01.NEU.0000249272.64439.B1","article-title":"A pilot study of neurocognitive function in patients with one to three new brain metastases initially treated with stereotactic radiosurgery alone","volume":"60","author":"Chang","year":"2007","journal-title":"Neurosurgery"},{"issue":"4","key":"10.1016\/j.surneu.2007.12.019_bib11","first-page":"860","article-title":"Radiosurgical salvage therapy for patients presenting with recurrence of metastatic disease to the brain","volume":"46","author":"Chen","year":"2000","journal-title":"Neurosurgery"},{"issue":"3","key":"10.1016\/j.surneu.2007.12.019_bib12","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1200\/JCO.1994.12.3.627","article-title":"Neurobehavioral sequelae of cranial irradiation in adults: a review of radiation-induced encephalopathy","volume":"12","author":"Crossen","year":"1994","journal-title":"J Clin Oncol"},{"issue":"3","key":"10.1016\/j.surneu.2007.12.019_bib13","doi-asserted-by":"crossref","first-page":"E3","DOI":"10.3171\/foc.2007.22.3.4","article-title":"Management of newly diagnosed single brain metastasis using resection and permanent iodine-125 seeds without initial whole-brain radiotherapy: a two institution experience","volume":"22","author":"Dagnew","year":"2007","journal-title":"Neurosurg Focus"},{"issue":"6","key":"10.1016\/j.surneu.2007.12.019_bib14","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1227\/00006123-198906000-00002","article-title":"The role of postoperative radiotherapy after resection of single brain metastases","volume":"24","author":"DeAngelis","year":"1989","journal-title":"Neurosurgery"},{"issue":"5 Suppl","key":"10.1016\/j.surneu.2007.12.019_bib15","first-page":"S66","article-title":"Current treatment paradigms for the management of patients with brain metastases","volume":"57","author":"Ewend","year":"2005","journal-title":"Neurosurgery"},{"issue":"4","key":"10.1016\/j.surneu.2007.12.019_bib16","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/0360-3016(94)90098-1","article-title":"A multi-institutional experience with stereotactic radiosurgery for solitary brain metastasis","volume":"28","author":"Flickinger","year":"1994","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.surneu.2007.12.019_bib17","first-page":"264","article-title":"Part III: radiosurgery in the treatment of brain metastases","volume":"51","author":"Friedman","year":"2004","journal-title":"Clin Neurosurg"},{"issue":"3","key":"10.1016\/j.surneu.2007.12.019_bib18","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.ijrobp.2006.01.024","article-title":"Gamma-Knife radiosurgery in the management of melanoma patients with brain metastases: a series of 106 patients without whole-brain radiotherapy","volume":"65","author":"Gaudy-Marqueste","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"6","key":"10.1016\/j.surneu.2007.12.019_bib19","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1227\/01.NEU.0000064569.18914.DE","article-title":"Brain metastases treated with radiosurgery alone: an alternative to whole brain radiotherapy?","volume":"52","author":"Hasegawa","year":"2003","journal-title":"Neurosurgery"},{"issue":"2","key":"10.1016\/j.surneu.2007.12.019_bib20","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1200\/JCO.1993.11.2.369","article-title":"Multiple brain metastases are associated with poor survival in patients treated with surgery and radiotherapy","volume":"11","author":"Hazuka","year":"1993","journal-title":"J Clin Oncol"},{"issue":"3","key":"10.1016\/j.surneu.2007.12.019_bib21","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1097\/01.SMJ.0000060569.47897.75","article-title":"Management strategies for patients with brain metastases: has radiosurgery made a difference?","volume":"97","author":"Jawahar","year":"2004","journal-title":"South Med J"},{"issue":"2","key":"10.1016\/j.surneu.2007.12.019_bib22","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0167-8140(03)00192-0","article-title":"Radiological and clinical assessment of long-term brain tumour survivors after radiotherapy","volume":"69","author":"Johannesen","year":"2003","journal-title":"Radiother Oncol"},{"issue":"3","key":"10.1016\/j.surneu.2007.12.019_bib23","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/S1042-3680(18)30365-6","article-title":"Demographics of brain metastasis","volume":"7","author":"Johnson","year":"1996","journal-title":"Neurosurg Clin N Am"},{"issue":"5","key":"10.1016\/j.surneu.2007.12.019_bib24","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/S1474-4422(05)70072-7","article-title":"Therapeutic management of brain metastasis","volume":"4","author":"Kaal","year":"2005","journal-title":"Lancet Neurol"},{"issue":"8","key":"10.1016\/j.surneu.2007.12.019_bib25","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1200\/JCO.2005.04.6185","article-title":"Whole-brain radiotherapy in the management of brain metastasis","volume":"24","author":"Khuntia","year":"2006","journal-title":"J Clin Oncol"},{"issue":"2","key":"10.1016\/j.surneu.2007.12.019_bib26","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/S0360-3016(99)00198-4","article-title":"Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases","volume":"45","author":"Kondziolka","year":"1999","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"10.1016\/j.surneu.2007.12.019_bib27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0733-8619(02)00035-X","article-title":"Brain metastases","volume":"21","author":"Lassman","year":"2003","journal-title":"Neurol Clin"},{"issue":"5","key":"10.1016\/j.surneu.2007.12.019_bib28","first-page":"1066","article-title":"Radiosurgery followed by planned observation in patients with one to three brain metastases","volume":"52","author":"Lutterbach","year":"2003","journal-title":"Neurosurgery"},{"issue":"4","key":"10.1016\/j.surneu.2007.12.019_bib29","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/0360-3016(92)90706-N","article-title":"Defining the role of radiosurgery in the management of brain metastases","volume":"24","author":"Mehta","year":"1992","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"7","key":"10.1016\/j.surneu.2007.12.019_bib30","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1002\/(SICI)1097-0142(19961001)78:7<1470::AID-CNCR14>3.0.CO;2-X","article-title":"A randomized trial to assess the efficacy of surgery in addition to radiotherapy in patients with a single cerebral metastasis","volume":"78","author":"Mintz","year":"1996","journal-title":"Cancer"},{"key":"10.1016\/j.surneu.2007.12.019_bib31","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jns.2004.11.027","article-title":"Neuropsychological evaluation of late-onset post-radiotherapy encephalopathy: a comparison with vascular dementia","volume":"229-230","author":"Moretti","year":"2005","journal-title":"J Neurol Sci"},{"issue":"1","key":"10.1016\/j.surneu.2007.12.019_bib32","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3171\/jns.1999.91.1.0035","article-title":"Surgery and radiotherapy compared with gamma knife radiosurgery in the treatment of solitary cerebral metastases of small diameter","volume":"91","author":"Muacevic","year":"1999","journal-title":"J Neurosurg"},{"issue":"5","key":"10.1016\/j.surneu.2007.12.019_bib33","first-page":"1021","article-title":"Reevaluation of surgery for the treatment of brain metastases: review of 208 patients with single or multiple brain metastases treated at one institution with modern neurosurgical techniques","volume":"56","author":"Paek","year":"2005","journal-title":"Neurosurgery"},{"issue":"17","key":"10.1016\/j.surneu.2007.12.019_bib34","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":"JAMA"},{"issue":"8","key":"10.1016\/j.surneu.2007.12.019_bib35","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJM199002223220802","article-title":"A randomized trial of surgery in the treatment of single metastases to the brain","volume":"322","author":"Patchell","year":"1990","journal-title":"N Engl J Med"},{"issue":"2","key":"10.1016\/j.surneu.2007.12.019_bib36","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/S0360-3016(01)01622-4","article-title":"Radiosurgery for patients with brain metastases: a multi-institutional analysis, stratified by the RTOG recursive partitioning analysis method","volume":"51","author":"Sanghavi","year":"2001","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"6","key":"10.1016\/j.surneu.2007.12.019_bib37","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1007\/s007010070104","article-title":"Defining the role of stereotactic radiosurgery versus microsurgery in the treatment of single brain metastases","volume":"142","author":"Schoggl","year":"2000","journal-title":"Acta Neurochir (Wien)"},{"issue":"6","key":"10.1016\/j.surneu.2007.12.019_bib38","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1667\/RR0588.1","article-title":"Spatial learning and memory deficits after whole-brain irradiation are associated with changes in NMDA receptor subunits in the hippocampus","volume":"166","author":"Shi","year":"2006","journal-title":"Radiat Res"},{"issue":"11","key":"10.1016\/j.surneu.2007.12.019_bib39","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1016\/0360-3016(87)90154-4","article-title":"Adjuvant radiation therapy after surgical resection of solitary brain metastasis: association with pattern of failure and survival","volume":"13","author":"Smalley","year":"1987","journal-title":"International journal of radiation oncology, biology, physics"},{"issue":"3","key":"10.1016\/j.surneu.2007.12.019_bib40","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S0360-3016(98)00447-7","article-title":"Radiosurgery for brain metastases: is whole brain radiotherapy necessary?","volume":"43","author":"Sneed","year":"1999","journal-title":"International journal of radiation oncology, biology, physics"},{"issue":"3","key":"10.1016\/j.surneu.2007.12.019_bib41","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/S0360-3016(02)02770-0","article-title":"A multi-institutional review of radiosurgery alone vs. radiosurgery with whole brain radiotherapy as the initial management of brain metastases","volume":"53","author":"Sneed","year":"2002","journal-title":"International journal of radiation oncology, biology, physics"},{"issue":"3-4","key":"10.1016\/j.surneu.2007.12.019_bib42","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1007\/BF01809265","article-title":"Linear accelerator and Greitz-Bergstrom's head fixation system in radiosurgery of single cerebral metastases. A report of 86 cases","volume":"121","author":"Valentino","year":"1993","journal-title":"Acta Neurochir (Wien)"},{"issue":"4","key":"10.1016\/j.surneu.2007.12.019_bib43","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.ijrobp.2004.12.092","article-title":"The impact of whole-brain radiation therapy on the long-term control and morbidity of patients surviving more than one year after gamma knife radiosurgery for brain metastases","volume":"62","author":"Varlotto","year":"2005","journal-title":"International journal of radiation oncology, biology, physics"},{"issue":"6","key":"10.1016\/j.surneu.2007.12.019_bib44","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1002\/ana.410330605","article-title":"Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery?","volume":"33","author":"Vecht","year":"1993","journal-title":"Ann Neurol"},{"issue":"4","key":"10.1016\/j.surneu.2007.12.019_bib45","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/0360-3016(90)90421-F","article-title":"Physics of gamma knife approach on convergent beams in stereotactic radiosurgery","volume":"18","author":"Wu","year":"1990","journal-title":"International journal of radiation oncology, biology, physics"},{"issue":"Suppl","key":"10.1016\/j.surneu.2007.12.019_bib46","doi-asserted-by":"crossref","first-page":"262","DOI":"10.3171\/sup.2005.102.s_supplement.0262","article-title":"Prolonged survival in a subgroup of patients with brain metastases treated by gamma knife surgery","volume":"102","author":"Yu","year":"2005","journal-title":"J Neurosurg"}],"container-title":["Surgical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0090301908000189?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0090301908000189?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T01:26:00Z","timestamp":1758763560000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0090301908000189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,3]]},"references-count":46,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2009,3]]}},"alternative-id":["S0090301908000189"],"URL":"https:\/\/doi.org\/10.1016\/j.surneu.2007.12.019","relation":{},"ISSN":["0090-3019"],"issn-type":[{"value":"0090-3019","type":"print"}],"subject":[],"published":{"date-parts":[[2009,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Combined surgical resection and stereotactic radiosurgery for treatment of cerebral metastases","name":"articletitle","label":"Article Title"},{"value":"Surgical Neurology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.surneu.2007.12.019","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2009 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}