{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:16:10Z","timestamp":1790806570701,"version":"4.1.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,10]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Therapeutic options for brain metastases (BMs) that recur after stereotactic radiosurgery (SRS) remain limited.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors provide the collective experience of 4 institutions where treatment of BMs that recurred after SRS was performed with stereotactic laser ablation (SLA).<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Twenty-six BMs (in 23 patients) that recurred after SRS were treated with SLA (2 patients each underwent 2 SLAs for separate lesions, and a third underwent 2 serial SLAs for discrete BMs). Histological findings in the BMs treated included the following: breast (n = 6); lung (n = 6); melanoma (n = 5); colon (n = 2); ovarian (n = 1); bladder (n = 1); esophageal (n = 1); and sarcoma (n = 1). With a median follow-up duration of 141 days (range 64\u2013794 days), 9 of the SLA-treated BMs progressed despite treatment (35%). All cases of progression occurred in BMs in which < 80% ablation was achieved, whereas no disease progression was observed in BMs in which \u2265 80% ablation was achieved. Five BMs were treated with SLA, followed 1 month later by adjuvant SRS (5 Gy daily \u00d7 5 days). No disease progression was observed in these patients despite ablation efficiency of < 80%, suggesting that adjuvant hypofractionated SRS enhances the efficacy of SLA. Of the 23 SLA-treated patients, 3 suffered transient hemiparesis (13%), 1 developed hydrocephalus requiring temporary ventricular drainage (4%), and 1 patient who underwent SLA of a 28.9-cm\n 3<\/jats:sup>\n lesion suffered a neurological deficit requiring an emergency hemicraniectomy (4%). Although there is significant heterogeneity in corticosteroid treatment post-SLA, most patients underwent a 2-week taper.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Stereotactic laser ablation is an effective treatment option for BMs in which SRS fails. Ablation of \u2265 80% of BMs is associated with decreased risk of disease progression. The efficacy of SLA in this setting may be augmented by adjuvant hypofractionated SRS.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.7.focus16227","type":"journal-article","created":{"date-parts":[[2016,10,1]],"date-time":"2016-10-01T03:37:26Z","timestamp":1475293046000},"page":"E11","source":"Crossref","is-referenced-by-count":66,"title":["Stereotactic laser ablation as treatment for brain metastases that recur after stereotactic radiosurgery: a multiinstitutional experience"],"prefix":"10.3171","volume":"41","author":[{"given":"Mir Amaan","family":"Ali","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate T.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Rennert","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hamelin","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon","family":"Chang","sequence":"additional","affiliation":[{"name":"Anesthesia, University of California, San Diego, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian P.","family":"Lemkuil","sequence":"additional","affiliation":[{"name":"Anesthesia, University of California, San Diego, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayur","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill S.","family":"Barnholtz-Sloan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospitals, Cleveland, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Myers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene H.","family":"Barnett","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza M.","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"Sloan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospitals, Cleveland, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clark C.","family":"Chen","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16227","series-title":"JAMA","first-page":"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"},{"issue":"1 Suppl 1","key":"b2-focus16227","series-title":"Neurosurgery","first-page":"ONS21","article-title":"Real-time magnetic resonance-guided laser thermal therapy for focal metastatic brain tumors","volume":"63","author":"Carpentier","year":"2008"},{"key":"b3-focus16227","series-title":"Curr Oncol Rep","first-page":"85","article-title":"Treatment of brain metastases: chemotherapy","volume":"14","author":"Grimm","year":"2012"},{"issue":"6","key":"b4-focus16227","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Stereotactic laser ablation of high-grade gliomas","volume":"37","author":"Hawasli","year":"2014"},{"key":"b5-focus16227","series-title":"Clin Neurol Neurosurg","first-page":"132","article-title":"Outcome of repeated radiosurgery for recurrent metastatic brain tumors","volume":"109","author":"Kwon","year":"2007"},{"key":"b6-focus16227","series-title":"J Neurosurg","first-page":"769","article-title":"Outcome predictors of Gamma Knife surgery for melanoma brain metastases. Clinical article","volume":"114","author":"Liew","year":"2011"},{"key":"b7-focus16227","series-title":"J Neurooncol","first-page":"119","article-title":"Management patterns of patients with cerebral metastases who underwent multiple stereotactic radiosurgeries","volume":"128","author":"Marshall","year":"2016"},{"key":"b8-focus16227","series-title":"Radiat Oncol","first-page":"48","article-title":"Stereotactic radiosurgery for brain metastases: analysis of outcome and risk of brain radionecrosis","volume":"6","author":"Minniti","year":"2011"},{"key":"b9-focus16227","series-title":"Cancer Med","first-page":"971","article-title":"The role of laser interstitial thermal therapy in enhancing progression-free survival of difficult-to-access high-grade gliomas: a multicenter study","volume":"3","author":"Mohammadi","year":"2014"},{"key":"b10-focus16227","series-title":"Stereotact Funct Neurosurg","first-page":"192","article-title":"Laser interstitial thermal therapy for focal cerebral radiation necrosis: a case report and literature review","volume":"90","author":"Rahmathulla","year":"2012"},{"key":"b11-focus16227","series-title":"Pract Radiat Oncol","first-page":"e37","article-title":"Local recurrence and survival following stereotactic radiosurgery for brain metastases from small cell lung cancer","volume":"5","author":"Rava","year":"2015"},{"issue":"Suppl 2","key":"b12-focus16227","series-title":"Neuro Oncol","first-page":"ii76","article-title":"The Neurologic Assessment in Neuro-Oncology (NANO) Scale: A tool to assess neurologic function for integration in the radiologic assessment in neuro-oncology (RANO) criteria","volume":"16","author":"Reardon","year":"2014"},{"key":"b13-focus16227","series-title":"Int J Radiat Oncol Biol Phys","first-page":"333","article-title":"Risk of symptomatic brain tumor recurrence and neurologic deficit after radiosurgery alone in patients with newly diagnosed brain metastases: results and implications","volume":"52","author":"Regine","year":"2002"},{"key":"b14-focus16227","series-title":"J Comput Assist Tomogr","first-page":"818","article-title":"Laser-induced thermal lesions in the human brain: short- and long-term appearance on MRI","volume":"21","author":"Schwabe","year":"1997"},{"key":"b15-focus16227","series-title":"J Neurosurg","first-page":"1202","article-title":"Results of the NeuroBlate System first-in-humans Phase I clinical trial for recurrent glioblastoma: clinical article","volume":"118","author":"Sloan","year":"2013"},{"key":"b16-focus16227","series-title":"Oncotarget","first-page":"12318","article-title":"Stereotactic radiosurgery (SRS) in the modern management of patients with brain metastases","volume":"7","author":"Soliman","year":"2016"},{"key":"b17-focus16227","series-title":"Stereotact Funct Neurosurg","first-page":"501","article-title":"Stereotactic interstitial laser-hyperthermia using Nd-YAG laser","volume":"54\u201355","author":"Sugiyama","year":"1990"},{"key":"b18-focus16227","series-title":"J Neurooncol","first-page":"495","article-title":"Stereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery","volume":"113","author":"Torres-Reveron","year":"2013"},{"key":"b19-focus16227","series-title":"J Neurooncol","first-page":"119","article-title":"Salvage stereotactic radiosurgery with adjuvant use of bevacizumab for heavily treated recurrent brain metastases: a preliminary report","volume":"127","author":"Yomo","year":"2016"},{"key":"b1-focus16227","series-title":"JAMA","first-page":"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"},{"issue":"1 Suppl 1","key":"b2-focus16227","series-title":"Neurosurgery","first-page":"ONS21","article-title":"Real-time magnetic resonance-guided laser thermal therapy for focal metastatic brain tumors","volume":"63","author":"Carpentier","year":"2008"},{"key":"b3-focus16227","series-title":"Curr Oncol Rep","first-page":"85","article-title":"Treatment of brain metastases: chemotherapy","volume":"14","author":"Grimm","year":"2012"},{"issue":"6","key":"b4-focus16227","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Stereotactic laser ablation of high-grade gliomas","volume":"37","author":"Hawasli","year":"2014"},{"key":"b5-focus16227","series-title":"Clin Neurol Neurosurg","first-page":"132","article-title":"Outcome of repeated radiosurgery for recurrent metastatic brain tumors","volume":"109","author":"Kwon","year":"2007"},{"key":"b6-focus16227","series-title":"J Neurosurg","first-page":"769","article-title":"Outcome predictors of Gamma Knife surgery for melanoma brain metastases. 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