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Therefore, we analyzed the outcome and toxicity of SRS alone compared to SRS in combination with TT\/IT.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients with MBM treated with single session SRS at our department between 2014 and 2017 with a minimum follow-up of 3\u2009months after first SRS were included. The primary endpoint of this study was local control (LC). Secondary endpoints were distant intracranial control, radiation necrosis-free survival (RNFS), and overall survival (OS). The local\/ distant intracranial control rates, RNFS and OS were analyzed using the Kaplan-Meier method. The log-rank test was used to test differences between groups. Cox proportional hazard model was performed for univariate continuous variables and multivariate analyses.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Twenty-eight patients (17 male and 11 female) with 52 SRS-lesions were included. The median follow-up was 19\u2009months (range 14\u201324\u2009months) after first SRS. Thirty-six lesions (69.2%) were treated with TT\/IT simultaneously (4\u2009weeks before and 4\u2009weeks after SRS), while 16 lesions (30.8%) were treated with SRS alone or with sequential TT\/IT. The 1-year local control rate was 100 and 83.3% for SRS with TT\/IT and SRS alone (<jats:italic>p<\/jats:italic>\u2009=\u20090.023), respectively. The estimated 1-year RNFS was 90.0 and 82.1% for SRS in combination with TT\/IT and SRS alone (<jats:italic>p<\/jats:italic>\u2009=\u20090.935). The distant intracranial control rate after 1\u2009year was 47.7 and 50% for SRS in combination with TT\/IT and SRS alone (<jats:italic>p<\/jats:italic>\u2009=\u20090.933). On univariate analysis, the diagnosis-specific Graded Prognostic Assessment including the BRAF status (Melanoma-molGPA) was associated with a significantly improved LC. Neither gender nor SRS-PTV margin had a prognostic impact on LC. V10 and V12 were significantly associated with RNFS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>p<\/jats:italic>\u2009=\u20090.004).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>SRS with simultaneous TT\/IT significantly improved LC with no significant difference in radiation necrosis rate. The therapy combination appears to be effective and safe. However, prospective studies on SRS with simultaneous TT\/IT are necessary and ongoing.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Trial registration<\/jats:title>\n<jats:p>The institutional review board approved this analysis on 10th of February 2015 and all patients signed informed consent (UE nr. 128\u201314).<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13014-020-1485-8","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T16:03:50Z","timestamp":1581696230000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Stereotactic radiosurgery combined with targeted\/ immunotherapy in patients with melanoma brain metastasis"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2931-1761","authenticated-orcid":false,"given":"Indrawati","family":"Hadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olarn","family":"Roengvoraphoj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Bodensohn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hofmaier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Niyazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Belka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke Birgit","family":"Nachbichler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,14]]},"reference":[{"key":"1485_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, et al. 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