Journal of Neuro-Oncology最新文献

{"title":"Survival prediction with radiomics for patients with IDH mutated lower-grade glioma.","authors":"Alice Neimantaite, Louise Carstam, Tomás Gómez Vecchio, Ida Häggström, Tora Dunås, Francesco Latini, Maria Zetterling, Malin Blomstrand, Jiri Bartek, Margret Jensdottir, Erik Thurin, Anja Smits, Asgeir S Jakola","doi":"10.1007/s11060-025-05006-z","DOIUrl":"10.1007/s11060-025-05006-z","url":null,"abstract":"<p><strong>Purpose: </strong>Adult patients with diffuse lower-grade gliomas (dLGG) show heterogeneous survival outcomes, complicating postoperative treatment planning. Treating all patients early increases the risk of long-term side effects, while delayed treatment may lead to impaired survival. Refinement of prognostic models could optimize timing of treatment. Conventional radiological features are prognostic in dLGG, but MRI could carry more prognostic information. This study aimed to investigate MRI-based radiomics survival models and compare them with clinical models.</p><p><strong>Methods: </strong>Two clinical survival models were created: a preoperative model (tumor volume) and a full clinical model (tumor volume, extent of resection, tumor subtype). Radiomics features were extracted from preoperative MRI. The dataset was divided into training set and unseen test set (70:30). Model performance was evaluated on test set with Uno's concordance index (c-index). Risk groups were created by the best performing model's predictions.</p><p><strong>Results: </strong>207 patients with mutated IDH (mIDH) dLGG were included. The preoperative clinical, full clinical and radiomics models showed c-indexes of 0.70, 0.71 and 0.75 respectively on test set for overall survival. The radiomics model included four features of tumor diameter and tumor heterogeneity. The combined full clinical and radiomics model showed best performance with c-index = 0.79. The survival difference between high- and low-risk patients according to the combined model was both statistically significant and clinically relevant.</p><p><strong>Conclusion: </strong>Radiomics can capture quantitative prognostic information in patients with dLGG. Combined models show promise of synergetic effects and should be studied further in astrocytoma and oligodendroglioma patients separately for optimal modelling of individual risks.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"505-514"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond surgical radicality in intramedullary spinal cord metastases: neurological function and systemic disease burden drive patient outcomes.","authors":"Meltem Ivren, Dilber Yalman, Basem Ishak, Sebastian Ille, Sandro M Krieg, Pavlina Lenga","doi":"10.1007/s11060-025-05119-5","DOIUrl":"https://doi.org/10.1007/s11060-025-05119-5","url":null,"abstract":"<p><strong>Purpose: </strong>Intramedullary spinal cord metastases (ISCM) are rare, clinically challenging lesions with limited evidence-based guidance. Optimal surgical management remains controversial, particularly regarding the ideal extent of resection (EOR) and associated prognostic factors. This study systematically evaluates perioperative outcomes, neurological function, and short-term survival according to biopsy-only, subtotal, or gross total resection (GTR) approaches.</p><p><strong>Methods: </strong>This retrospective single-center study included 16 patients treated surgically for histologically confirmed ISCM between 2015 and 2024. Patients were stratified by surgical extent (biopsy, subtotal, or total resection). Outcomes included perioperative complications, neurological function, and 90-day survival. A literature review of surgical ISCM series (≥ 5 cases) was also performed.</p><p><strong>Results: </strong>Sixteen patients with a median age of 59 years (56% male) were included. Thoracic lesions predominated (56%). Surgical complications were seen in 19% of the cases, however no irreversible neurological injury and no intraoperative mortality or transfusion occured. Early mortality was lowest following GTR (13%) compared to subtotal (60%) or biopsy-only (33%) approaches (p = 0.015). However, multivariable regression showed that EOR alone was not independently predictive of short-term survival (p = 0.834), indicating patient selection bias. Neurological function remained stable or improved in all of cases, irrespective of resection extent.</p><p><strong>Conclusion: </strong>Surgical management of ISCM can be performed safely with minimal neurological morbidity, achieving symptom stabilization or improvement. Although GTR was associated with favorable short-term survival, systemic disease burden and postoperative neurological function are stronger prognostic factors. Therefore, surgical decisions should prioritize functional preservation and patient selection based on disease extent and overall health.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of leptomeningeal disease after only vertebral osseous metastases: a real-world analysis using the TriNetX database.","authors":"Ryan Gensler, Yuanxuan Xia, Melanie Alfonzo Horowitz, Mostafa Abdulrahim, Nathan Hyson, Kristin Redmond, Daniel Lubelski, Nicholas Theodore, David Kamson, Chetan Bettegowda, Yuxuan Wang","doi":"10.1007/s11060-025-05122-w","DOIUrl":"https://doi.org/10.1007/s11060-025-05122-w","url":null,"abstract":"<p><strong>Purpose: </strong>Leptomeningeal disease (LMD) is a morbid complication of systemic cancer typically associated with brain metastases. However, vertebral bone metastases may also serve as a route for cerebrospinal fluid spread, though this pathway is less characterized. This study aims to determine the incidence, timing, and outcomes of LMD in patients with vertebral metastases in the absence of brain or other systemic metastases, using a large real-world database.</p><p><strong>Methods: </strong>Using the TriNetX global health research network (n = 133 million), we identified 7887 adult patients with vertebral metastases from common solid tumors (lung, breast, prostate, colorectal, renal, melanoma, thyroid) who had no brain metastases or other potential sources of LMD. Patients were followed to identify development of LMD, and cohorts were compared based on metastatic pathways and clinical outcomes.</p><p><strong>Results: </strong>Among 7887 patients with vertebral metastases, 144 (1.8%) developed LMD without prior or concurrent brain or systemic metastases, isolating the spine as the sole source. Breast cancer had the highest LMD rate (36.8%), followed by lung (20.8%), prostate (18.8%), and colorectal (11.1%). Median time from vertebral metastasis to LMD was 97.5 days (IQR 17-550), longer than the 50-day median (IQR 12-182) in patients with brain metastases before LMD (p < 0.001). Patients with vertebral metastases alone developed LMD significantly earlier than those with other prior metastases (median 97.5 vs. 250 days, IQR 100-775, p < 0.01). LMD was associated with shorter overall survival (median 170 vs. 370 days, p = 0.0006; HR 0.61, 95% CI 0.46-0.81), particularly in breast cancer (170 vs. 1001 days, p < 0.01). LMD patients were more likely to require hospice or palliative care (39.6% vs. 22.2%, p < 0.001), while non-LMD patients more often reported pain (67.1% vs. 52.4%, p = 0.0113) and emotional distress (45.8% vs. 26.4%, p = 0.007). Survival after LMD diagnosis was similarly poor regardless of metastatic pathway (p = 0.966).</p><p><strong>Conclusion: </strong>Vertebral metastases can serve as an underrecognized route of LMD spread, even in the absence of brain or other systemic metastases. LMD following vertebral disease is associated with poor prognosis and increased palliative care utilization. These findings underscore the need for heightened clinical vigilance for LMD in patients with spinal metastases.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CPT-SIOP registry: evaluation of risk factors for disease progression in pediatric choroid plexus papilloma.","authors":"Christian Fiedler, Uwe R Kordes, Christian Thomas, Martin Hasselblatt, Brigitte Bison, Lars Behrens, Martin Mynarek, Rolf-Dieter Kortmann, Beate Timmermann, Torsten Pietsch, Jenny Adamski, Johannes E A Wolff, Stefan Rutkowski, Denise Obrecht-Sturm","doi":"10.1007/s11060-025-05136-4","DOIUrl":"https://doi.org/10.1007/s11060-025-05136-4","url":null,"abstract":"","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior parasagittal meningiomas display aggressive features independent of size: a multicenter analysis.","authors":"Said Koçyiğit, Miguel Millares Chavez, Ömer Orhun, Joseph O'Brien, Arda Inan, A Harun Yaşar, Alp Dinçer, Jennifer Moliterno, Murat Günel, M Necmettin Pamir, Koray Özduman, Ayça Erşen-Danyeli","doi":"10.1007/s11060-025-05103-z","DOIUrl":"https://doi.org/10.1007/s11060-025-05103-z","url":null,"abstract":"<p><strong>Purpose: </strong>While meningioma size is known to correlate with higher histological grade, tumor behavior can vary by anatomical location, suggesting that some meningiomas may exhibit aggressive features early and independent of size. We hypothesized that posterior parasagittal meningiomas possess unique growth characteristics and tested this hypothesis using a retrospective analysis of two independent cohorts.</p><p><strong>Methods: </strong>Cohort-A (n = 316) included 123 WHO-grade 2 (GR2) and 193 age and location matched WHO-grade 1 (GR1) meningiomas. Twelve radiological features as well as the histological subtypes, histological grading features and 1p status was evaluated. A volume index (V_i), defined as the GR2/GR1 tumor volume ratio, was calculated across different anatomical locations. Findings were validated in Cohort-B (n = 477), which also included NF2-driven and non-NF2-driven molecular subsets.</p><p><strong>Results: </strong>Tumor volume correlated strongly with GR2 status (p = 3.5 × 10^- 6) and histopathological markers of major grading criteria including mitotic count (p < 0.001), brain invasion (p < 0.05), and minor grading criteria including hypercellularity (p < 0.001), necrosis (p < 0.001) along with increased Ki67 index (p < 0.01). Anatomically, the non-skull base posterior midline (NSB-POST-M) meningiomas had the lowest V_i in both cohorts and the NF2-driven subset indicating that these tumors exhibit aggressive features even at smaller sizes. The NSB-POST-M location had the highest proportion of GR2 cases, mean Ki67 index, and incidence of chromosome 1p loss.</p><p><strong>Conclusions: </strong>While larger meningiomas are generally more aggressive, posterior parasagittal meningiomas display aggressive biology regardless of size. These findings suggest that anatomical location should be incorporated into risk stratification and management decisions.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of proton versus photon radiotherapy on overall survival in the management of spinal chordoma and mortality risk prediction: a nationwide analysis.","authors":"Abdul Karim Ghaith, Xinlan Yang, Taha Khalilullah, Linda Tang, Hasan Radwan, Joshua Weinberg, Jawad Khalifeh, A Karim Ahmed, Tej Azad, Chase Foster, Nicholas Theodore, Kristin J Redmond, Daniel Lubelski","doi":"10.1007/s11060-025-05104-y","DOIUrl":"https://doi.org/10.1007/s11060-025-05104-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to provide a national-level insight into the optimal management of spinal chordoma, a type of rare and complicated malignancy, and to identify effective radiation therapy (RT) strategies for patients with spinal chordoma by comparing photon versus proton therapies.</p><p><strong>Methods: </strong>Patients with histologically confirmed spinal chordoma were identified from the NCDB. Patients' demographics, disease characteristics and treatments were compared between the radiation and no-radiation groups. Kaplan-Meier assessed 10-year overall survival (OS). Multivariate Cox regression and machine learning models-Random Survival Forest and Gradient Boosting-identified predictive factors and thresholds of tumor size for mortality risk, with SHAP used to quantify predictor importance.</p><p><strong>Results: </strong>Of 1204 patients, 495 (41.1%) received RT; 73.9% received photons and 26.1% protons. GTR significantly improved OS compared to STR (p < 0.0001). RT was associated with reduced short-term morality at 90-days (p = 0.025) and 1-year (p = 0.016). Proton therapy showed superior 10-year OS compared to photon therapy (p = 0.019). Beam technology, BED dose, sequence, and reirradiation had minimal impact on OS. Cox regression identified age (HR = 1.03, p < 0.001), STR (HR = 1.42, p = 0.005), and proton therapy (HR = 0.58, p = 0.044) as independent mortality predictors. Machine learning identified tumor size thresholds (photons: 83 mm; protons: 70 mm) and ranked age, tumor size, and EOR as top survival predictors.</p><p><strong>Conclusion: </strong>Aggressive surgical resection (GTR) remains the primary treatment for spinal chordoma. Proton therapy that allows for dose escalation provided 10-year survival benefits compared to photon therapy. Age, tumor size and EOR are important factors in predicting 10-year mortality risk.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The landscape of germline variants in breast and colorectal cancer susceptibility genes in patients with pituitary tumours.","authors":"Andreas Orsmond, Sunita M C De Sousa, Ann McCormack","doi":"10.1007/s11060-025-05140-8","DOIUrl":"https://doi.org/10.1007/s11060-025-05140-8","url":null,"abstract":"<p><strong>Purpose: </strong>Heritable genetic contributions to familial and sporadic pituitary tumorigenesis are poorly understood. There is emerging evidence that germline variants in classical cancer susceptibility genes may increase the risk of pituitary tumour development. We aimed to identify and assess the rate of pathogenic germline variants in breast and colorectal cancer susceptibility genes that may promote pituitary tumorigenesis.</p><p><strong>Methods: </strong>Using a next-generation sequencing panel, we analysed 26 cancer susceptibility genes in 136 patients with suspected familial or sporadic pituitary tumours. Rates of pathogenic germline variation were compared against the gnomAD database.</p><p><strong>Results: </strong>We identified nine pathogenic or likely pathogenic germline variants in eight patients, within ATM, BRCA2, CHEK2, MUTYH, MLH1 and APC. We also detected three pathogenic somatic variants in TP53 and MSH6 in two patients. Compared to the general population, more pathogenic germline variants in cancer predisposition genes were found in patients with pituitary tumours (relative rate 1.44, p = 0.46), particularly in mismatch repair genes, albeit not statistically significant. We additionally identified a trend of a larger burden of pathogenic cancer susceptibility gene variants in individuals with classical pituitary tumour predisposition pathogenic variants, compared to those without (29% vs. 4.7%, p = 0.057).</p><p><strong>Conclusion: </strong>Our study provides a basis for ongoing research into the potential role of cancer susceptibility genes in driving pituitary tumorigenesis.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular and clinical determinants of response to checkpoint inhibitor immunotherapy in glioblastoma.","authors":"Pushan Dasgupta, Heather Lin, Gayatri Kumar, Zaid Soomro, Max M Ayala, Edwin R Parra, Shiao-Pei Weathers, Frederick F Lang, Krishna P Bhat, John de Groot, Nazanin K Majd","doi":"10.1007/s11060-025-05131-9","DOIUrl":"https://doi.org/10.1007/s11060-025-05131-9","url":null,"abstract":"<p><strong>Purpose: </strong>While checkpoint inhibitor therapy (CPI) has transformed treatment in multiple solid tumors, its efficacy in glioblastoma (GBM) remains limited. Understanding the molecular and clinical factors that influence glioblastoma's response to CPI is essential to improving outcomes.</p><p><strong>Methods: </strong>We identified patients with recurrent GBM, who had been treated with CPI and determined the association between their molecular, clinical, and demographic characteristics and survival outcomes.</p><p><strong>Results: </strong>We identified 35 patients with recurrent GBM treated with CPI. PIK3CA mutation was associated with a statistically significant shorter OS duration, calculated from CPI initiation (p-value = 0.014). Tumor tissue without the mutation had less PD-1 expression in CD3+/CD8 + T cells. RB1 and TERT promoter mutations were associated with shorter PFS durations (p-value = 0.009, 0.053, respectively). Length of CPI therapy of more than 6 months was associated with increased PFS and OS (p-value = 0.069, 0.088, respectively), while steroid use at baseline was associated with a shorter OS (p-value = 0.0016). Multifocal disease was associated with shorter PFS and OS durations (p-value = 0.0011, 0.0015, respectively) among all patients.</p><p><strong>Conclusions: </strong>In glioblastoma, PIK3CA, RB1, TERT promoter mutations, steroid use prior to start of CPI, and multifocal disease may be associated with a poor response to CPI while increased length of CPI may be associated with improved response. Our results may provide the rationale for clinical trials combining PI3K inhibitors with CPI in glioblastoma. The small sample size and retrospective nature of the study carries selection bias and/or confounding effects and larger studies need to be done to validate these results.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glioblastoma cell motility and invasion is regulated by membrane-associated heat shock protein Hsp70.","authors":"Ruslana Likhomanova, Elena Oganesyan, Natalia Yudintceva, Georgii Fofanov, Anastasiia Nechaeva, Alexei Ulitin, Aleksander Kim, Nikolay Aksenov, Alla Shatrova, Rustam Ziganshin, Danila Bobkov, Konstantin Samochernykh, Stephanie E Combs, Maxim Shevtsov","doi":"10.1007/s11060-025-05127-5","DOIUrl":"https://doi.org/10.1007/s11060-025-05127-5","url":null,"abstract":"","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cesium-131 collagen tile brachytherapy for salvage of recurrent intracranial metastases.","authors":"Thomas H Beckham, Elaine E Cha, Michael K Rooney, Martin C Tom, Subha Perni, Mary Frances McAleer, Jing Li, Rajat J Kudchadker, Surendra Prajapati, Yana Zlateva, Diana Kaya, Chibawanye I Ene, Sherise D Ferguson, Jason T Huse, Sujit S Prabhu, Jeffrey S Weinberg","doi":"10.1007/s11060-025-05113-x","DOIUrl":"https://doi.org/10.1007/s11060-025-05113-x","url":null,"abstract":"<p><strong>Purpose: </strong>Management of brain metastases (BM) that recur after stereotactic radiosurgery (SRS) (rBM) is challenging. We reviewed our experience with resection with Cs-131 collagen tile brachytherapy for rBM.</p><p><strong>Methods: </strong>Patients with rBM after SRS salvaged with resection and Cs-131 brachytherapy were reviewed. Analyses included descriptive statistics, Kaplan-Meier for overall survival (OS), Fine and Gray modeling for subgroup comparisons, and cumulative incidence of LF (CILF).</p><p><strong>Results: </strong>Thirty-one patients (38 surgical cavities) were reviewed; primaries were most commonly breast (37%) or non-small cell lung cancer (26%). All BMs had received prior SRS to a median 20 Gy in 1 fraction at a median 12.3 months before tile implantation; disease in 32 cavities (84%) was gross totally resected. At a median patient follow-up time of 11.8 months, LF developed in 6 of 38 cavities (16%); with CILF 7.9% at 6 months and 13% at 1 year. Risk factors for LF included > 1 prior radiation courses (HR 2.44; p = 0.001), subtotal resection (HR 6.99; p = 0.015), tumor volume (HR 1.04; p = 0.006), and degree of dural contact (p < 0.001). One-year OS rate was 65.8%. Three cavities (8%) among two patients (6%) developed grade 2 + radionecrosis. Two patients developed classical leptomeningeal disease (LMD) and two patients had nodular dural seeding for an overall incidence of LMD of 12.9%.</p><p><strong>Conclusions: </strong>Salvage resection with Cs-131 collagen tile brachytherapy for rBM after SRS provides favorable local control with minimal toxicity. Lesion characteristics may help to identify patients at increased risk for LF.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}