{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:55:48Z","timestamp":1788382548946,"version":"build-2803163510"},"reference-count":39,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Accounting for approximately 15% of primary liver cancers and 3% of gastrointestinal malignancies, cholangiocarcinoma (CCA) poses a serious health concern given its high mortality rate. Managing brain metastases (BMs) from CCA is challenging because of their rarity and poor prognosis, with little guidance on treatment from the literature. In this study, the authors aimed to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) in managing BMs from CCA.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This multicenter retrospective study included 13 CCA patients with 41 BMs treated with SRS from October 2006 to April 2022 at eight institutions affiliated with the International Radiosurgery Research Foundation. Inclusion criteria were a CCA diagnosis, an age over 18 years, no other malignancies, single-fraction SRS treatment for BMs, and at least one follow-up image. Data on demographics, tumor characteristics, treatment details, and outcomes were collected. The primary endpoints were local control (LC), intracranial progression-free survival (PFS), and overall survival (OS). The secondary endpoint was the development of adverse radiation effects (AREs).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The median radiological follow-up was 5 months (range 1\u201318 months). At the last follow-up, LC was achieved in 39 (95.1%) of 41 BMs. New distant metastases were observed in 3 patients (23.1%), and the mean intracranial PFS was 9.4 months (95% CI 6.5\u201312.3 months). Six-month and 1-year OS rates were 38.5% and 11.5%, respectively, and the median OS was 6 months (95% CI 4.9\u20137.2 months). Concurrent immunotherapy was associated with a high risk of local failure (HR 29.665, 95% CI 1.799\u2013489.206, p = 0.018), and the absence of systemic chemotherapy before SRS was linked to reduced OS (HR 6.658, 95% CI 1.173\u201337.776, p = 0.032). Regarding AREs, only 1 patient (7.7%) experienced right hemiparesis and was treated with corticosteroid therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>SRS is an effective option for managing BMs in CCA patients, showing promise in LC and a high safety profile.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.2.jns2483","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T03:01:18Z","timestamp":1715396478000},"page":"1324-1331","source":"Crossref","is-referenced-by-count":3,"title":["Stereotactic radiosurgery for brain metastasis from cholangiocarcinoma"],"prefix":"10.3171","volume":"141","author":[{"given":"Ali Haluk","family":"D\u00fczkalir","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Center, Koc University Hospital, Istanbul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yavuz","family":"Samanci","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Center, Koc University Hospital, Istanbul;"},{"name":"Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Chia","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"National Yang Ming Chiao Tung University School of Medicine, Hsinchu, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huai-Che","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"National Yang Ming Chiao Tung University School of Medicine, Hsinchu, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Niranjan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Dade","family":"Lunsford","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhishuo","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka N.","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Dayawansa","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P.","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e9 de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Quebec, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad E.","family":"Zacharia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Penn State Health\u2013Hershey Medical Center, Hershey, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Santhumayor","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University Langone, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Kondziolka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University Langone, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selcuk","family":"Peker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Center, Koc University Hospital, Istanbul;"},{"name":"Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Scand J Gastroenterol","first-page":"183","article-title":"Clinical characteristics and prognosis of early-onset cholangiocarcinoma: a population-based study","volume":"59","author":"Gao F","year":"2024","unstructured":"Gao F, Xu X, Sun Y. 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