{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T01:39:50Z","timestamp":1769305190355,"version":"3.49.0"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"Supplement","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2006,12]]},"abstract":"Object<\/jats:title>The authors analyzed the effectiveness of Gamma Knife surgery (GKS) for metastatic brain tumors without adjuvant prophylactic whole-brain radiotherapy (WBRT). Salvage GKS was performed as the sole treatment for new distant lesions.<\/jats:p><\/jats:sec>Methods<\/jats:title>Among 1127 patients in whom new brain metastases had been diagnosed, 97 who met one or more of the following three criteria were excluded from the study: any surgically inaccessible huge (\u2265 35 mm) lesion; tumor number and size requiring an internal skull dose exceeding 10 J; or symptomatic carcinomatous meningitis. Thus, 1030 consecutive patients formed the basis for this study. Huge tumors were totally removed, whereas smaller lesions were treated with GKS. No adjuvant WBRT was given prior to GKS, and new distant lesions were appropriately retreated with GKS. Overall, neurological and new lesion\u2013free survival curves were calculated and the prognostic values of covariates were obtained. In total, 1853 separate GKS sessions were required to treat 10,163 lesions.The patients' median overall survival period was 8.6 months. Neurological survival and new lesion\u2013free rates at 1 year were 89.1 and 49.3%, respectively. In a multivariate analysis, the significant factors for poor prognosis were the development of more than four new brain metastases and active extracranial disease.<\/jats:p><\/jats:sec>Conclusions<\/jats:title> In meeting the goal of preventing neurological death and maintaining activities of daily living for patients with brain metastases, GKS alone provides excellent palliation without prophylactic WBRT. New distant lesions were quite well controlled with GKS salvage treatment alone.<\/jats:p><\/jats:sec>","DOI":"10.3171\/sup.2006.105.7.86","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T07:24:52Z","timestamp":1542353092000},"page":"86-90","source":"Crossref","is-referenced-by-count":28,"title":["Gamma Knife surgery for metastatic brain tumors without prophylactic whole-brain radiotherapy: results in 1000 consecutive cases"],"prefix":"10.3171","volume":"105","author":[{"given":"Toru","family":"Serizawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Higuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Ono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinji","family":"Matsuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Nagano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Iwadate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naokatsu","family":"Saeki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"B1","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"2483","DOI":"10.1001\/jama.295.21.2483","article-title":"Stereotactic radiosurgery plus whole brain radiation therapy vs stereotactcic radiosurgery alone for treatment of brain metastases: a randomized controlled trial","volume":"295","author":"Aoyama","year":"2006"},{"key":"B2","series-title":"J Nat Cancer Inst","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1093\/jnci\/87.3.183","article-title":"Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission","volume":"87","author":"Arriagada","year":"1995"},{"key":"B3","series-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"publisher","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"},{"key":"B4","series-title":"N Engl J Med","doi-asserted-by":"publisher","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"},{"key":"B5","series-title":"J Neurosurg (Suppl 3)","first-page":"32","article-title":"Gamma Knife treatment for multiple metastatic brain tumors compared with whole-brain radiation therapy","volume":"93","author":"Serizawa","year":"2000"},{"key":"B6","series-title":"J Neurosurg (Suppl 5)","first-page":"484","article-title":"Gamma Knife radiosurgery for metastatic brain tumors from lung cancer. 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