Hypofractionated Stereotactic Radiosurgery for Brain Metastases
Bibliographic record
Abstract
Hypofractionated stereotactic radiotherapy (HSRT) with modern image-guidance is a method for the treatment of brain metastases, which differs technically and radiobiologically from traditional single-fraction stereotactic radiosurgery (SRS). HSRT is based on a non-invasive mask-based treatment platform, and fractionates stereotactic intracranial treatment into 5 or fewer fractions. The intent of HSRT is to maximize the therapeutic ratio by enabling safe and effective treatment of large brain metastases, for re-irradiation of brain metastases, and for those metastases in close proximity to (or within) critical organs-at-risk that would normally preclude effective single-fraction SRS. In this review, we first summarize the current state of knowledge with respect to the epidemiology and treatment of brain metastases. Next, we discuss the rationale for HSRT and present the evidence supporting HSRT for the treatment of large intact brain metastases. Then, we discuss the evidence for treating post-operative brain metastases cavities with HSRT. Lastly, we present the evidence for multi-staged HSRT for brain metastases as a novel alternative to standard daily HSRT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.017 | 0.013 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".