{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:42:51Z","timestamp":1754163771347,"version":"3.41.2"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":194,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Stereotactic radiotherapy (SRT) is the main treatment for patients with 1 to 3\u20135 brain metastases (BMs) but with the compromise of a higher risk of distant brain failure (DBF) in comparison with whole brain radiotherapy. Early DBF has a significant negative impact on overall survival (OS). We propose to build and validate a prediction model of early DBF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Early DBF was defined as the appearance of unknown BMs on the first post-SRT magnetic resonance imaging (MRI). A nomogram was built for the prediction of early DBF using patients from a cohort of 537 SRT courses. The nomogram was evaluated for early DBF classification using the chi-squared test. Prediction of DBF-free survival and OS was tested using Kaplan\u2013Meier curves and the log-rank test. The model was validated on an external cohort of 160 subsequently delivered SRT courses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the cohort of 537 SRT courses, early DBF occurred in 17% cases. The number of BMs and the DS-GPA score were significant predictors of early DBF. The nomogram demonstrated robust performances for early DBF classification (\u03c72 23.7, P\u2005&amp;lt;\u2005.0001), DBF-free survival (\u03c72 35.5 P\u2005&amp;lt;\u2005.0001, Figure 1), and OS (\u03c72 38.9, P\u2005&amp;lt;\u2005.0001). On the validation cohort, the same nomogram achieved a \u03c72 of 15.3, P\u2005=\u2005.0005 for DBF-free survival and a \u03c72 of 8.6, P\u2005=\u2005.01 for OS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our study provides a robust predictive model for early DBF, validated in an independent cohort. This nomogram could improve clinical outcomes and treatment personalization.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/noajnl\/vdaf151","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T05:24:27Z","timestamp":1752470667000},"source":"Crossref","is-referenced-by-count":0,"title":["Prediction of early distant brain failure after stereotactic radiotherapy for brain metastases"],"prefix":"10.1093","volume":"7","author":[{"given":"Moncef","family":"Morjani","sequence":"first","affiliation":[{"name":"Radiation Oncology Department, University Hospital , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brieg","family":"Dissaux","sequence":"additional","affiliation":[{"name":"INSERM, GETBO UMR 1304, University of Western Brittany , Brest ,","place":["France"]},{"name":"Radiology Department, University Hospital , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Pradier","sequence":"additional","affiliation":[{"name":"INSERM, LaTIM UMR 1101, University of Western Brittany , Brest ,","place":["France"]},{"name":"Radiation Oncology Department, University Hospital , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sol\u00e8ne","family":"Querellou","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, University Hospital , Brest ,","place":["France"]},{"name":"INSERM, GETBO UMR 1304, University of Western Brittany , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romuald","family":"Seizeur","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, University Hospital , Brest ,","place":["France"]},{"name":"INSERM, LaTIM UMR 1101, University of Western Brittany , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, University Hospital , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Schick","sequence":"additional","affiliation":[{"name":"INSERM, LaTIM UMR 1101, University of Western Brittany , Brest ,","place":["France"]},{"name":"Radiation Oncology Department, University Hospital , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Lucia","sequence":"additional","affiliation":[{"name":"INSERM, LaTIM UMR 1101, University of Western Brittany , Brest ,","place":["France"]},{"name":"Radiation Oncology Department, University Hospital , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gurvan","family":"Dissaux","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, University Hospital , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2631-0029","authenticated-orcid":false,"given":"Vincent","family":"Bourbonne","sequence":"additional","affiliation":[{"name":"INSERM, LaTIM UMR 1101, University of Western Brittany , Brest ,","place":["France"]},{"name":"Radiation Oncology Department, University Hospital , Brest ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"issue":"5","key":"2025073108164709900_CIT0001","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"},{"issue":"4","key":"2025073108164709900_CIT0002","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.prro.2022.02.003","article-title":"Radiation therapy for brain metastases: an ASTRO Clinical Practice Guideline","volume":"12","author":"Gondi","year":"2022","journal-title":"Pract. 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