Stereotactic radiotherapy in brain metastases: SRS/FSRT paradox and preferences of radiation oncologists in Türkiye (TROD 10-010 study)
Strahlentherapie und Onkologie, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00066-026-02586-1
- Dergi Adı: Strahlentherapie und Onkologie
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, BIOSIS, CINAHL, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest), Technology Collection (ProQuest)
- Anahtar Kelimeler: Brain metastases, Fractionation, Hypofractionated radiotherapy, Practice patterns, Stereotactic radiosurgery, Survey
- Hacettepe Üniversitesi Adresli: Evet
Özet
Purpose: Brain metastases (BM) are the most common intracranial malignancies. However, the lack of high-level evidence comparing single- and multi-fraction stereotactic radiotherapy (SRT) results in substantial practice variability. We aimed to assess fractionation preferences and clinical decision-making among radiation oncologists (ROs) in Turkey. Materials and methods: A 21-question nationwide survey was conducted among ROs performing stereotactic treatment for BM. Responses were analyzed by clinical experience (> 10 vs ≤ 10 years). Results: A total of 111 ROs participated; 77% had > 10 years of experience. Linac-based SRS was most commonly used (84%). Although 42% favored preoperative SRS, only 12% implemented it. The main factors influencing the choice of SRS over WBRT were number (42%) and volume (33%) of metastases. Junior ROs prioritized lesion number, whereas senior ROs adopted a more multifactorial approach. Most participants used both SRS and FSRT (57%). Fractionation decisions were primarily driven by lesion volume (83%), proximity to organs at risk (76%), size (75%), and location (74%). SRS was preferred for smaller, peripherally located lesions without prior WBRT. Conclusion: Fractionation strategies vary widely and are influenced by clinical experience, underscoring the need for prospective evidence and standardized guidance.