000306185 001__ 306185 000306185 005__ 20251222115946.0 000306185 0247_ $$2doi$$a10.1016/j.radonc.2025.111279 000306185 0247_ $$2pmid$$apmid:41232776 000306185 0247_ $$2ISSN$$a0167-8140 000306185 0247_ $$2ISSN$$a1879-0887 000306185 037__ $$aDKFZ-2025-02425 000306185 041__ $$aEnglish 000306185 082__ $$a610 000306185 1001_ $$aSchiele, Annabella$$b0 000306185 245__ $$aPrognostic scores for patients with multiple brain metastases treated with repeated stereotactic radiosurgery - a secondary analysis of the CYBER-SPACE randomized phase 2 trial. 000306185 260__ $$aAmsterdam [u.a.]$$bElsevier Science$$c2026 000306185 3367_ $$2DRIVER$$aarticle 000306185 3367_ $$2DataCite$$aOutput Types/Journal article 000306185 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1766401145_3634860 000306185 3367_ $$2BibTeX$$aARTICLE 000306185 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000306185 3367_ $$00$$2EndNote$$aJournal Article 000306185 500__ $$aVolume 214, January 2026, 111279 000306185 520__ $$aStereotactic radiosurgery (SRS) is frequently combined with modern systemic therapy for brain metastases (BM). Most established prognostic scores were developed from historical cohorts and may not reflect current treatment standards. The randomized phase II CYBER-SPACE trial investigated upfront and repeated SRS for up to ten simultaneous BMs during systemic therapy, aiming to avoid whole-brain radiotherapy (WBRT). This secondary analysis evaluates the validity of established scores in this contemporary cohort.Assessed scores included the Recursive Partitioning Analysis (RPA), modified RPA (M-RPA), Graded Prognostic Assessment (GPA), diagnosis-specific GPA (dsGPA), lung-mol GPA, Basic Score for Brain Metastases (BSBM), Score Index for Radiosurgery (SIR), and Brain Metastasis Velocity (BMV) score. Their predictive value for overall survival (OS) and WBRT indication (WBRTi; defined as > 10 simultaneous BMs or leptomeningeal disease) was analysed. The BMV score was calculated at first through fourth distant brain failure (DBF). Kaplan-Meier analyses and log-rank tests were used.A total of 202 patients were enrolled. Common primary tumors were non-small cell lung cancer (63 %), melanoma (16 %), and breast cancer (10 %). Median OS after initial SRS was 13.1 months (Q1-Q3: 5.2-45.0). At 24 months, 40 patients (20.8 %) reached WBRTi. The dsGPA for melanoma (OS: p = 0.014; WBRTi: p = 0.042) and BMV (OS and WBRTi: p < 0.0001) were predictive for both endpoints; BSBM was predictive for OS only (p = 0.0011). The BMV remained prognostic through the fourth recurrence. Two endpoint-specific BMV cut-offs were identified, separating two prognostic groups for survival and WBRTi, respectively (p < 0.0001).BMV was the only score able to predict both OS and WBRTi across all tumor types. Two distinct endpoint-specific BMV cut-offs may support clinical decision-making between continued SRS and early WBRT, but warrant further external validation. 000306185 536__ $$0G:(DE-HGF)POF4-315$$a315 - Bildgebung und Radioonkologie (POF4-315)$$cPOF4-315$$fPOF IV$$x0 000306185 588__ $$aDataset connected to CrossRef, PubMed, , Journals: inrepo02.dkfz.de 000306185 650_7 $$2Other$$aBrain metastases 000306185 650_7 $$2Other$$aPrognostic score 000306185 650_7 $$2Other$$aRadiosurgery 000306185 650_7 $$2Other$$aStereotactic radiotherapy 000306185 650_7 $$2Other$$aValidation 000306185 650_7 $$2Other$$awhole-brain radiotherapy (WBRT) 000306185 7001_ $$aBernhardt, Denise$$b1 000306185 7001_ $$aWelzel, Thomas$$b2 000306185 7001_ $$aThalmann, Paul$$b3 000306185 7001_ $$aKönig, Laila$$b4 000306185 7001_ $$aEichkorn, Tanja$$b5 000306185 7001_ $$aKrämer, Anna$$b6 000306185 7001_ $$aLang, Kristin$$b7 000306185 7001_ $$aLentz-Hommertgen, Adriane$$b8 000306185 7001_ $$aWeykamp, Fabian$$b9 000306185 7001_ $$aBozorgmehr, Farastuk$$b10 000306185 7001_ $$aThomas, Michael$$b11 000306185 7001_ $$aSander, Anja$$b12 000306185 7001_ $$aRieken, Stefan$$b13 000306185 7001_ $$0P:(DE-He78)8714da4e45acfa36ce87c291443a9218$$aDebus, Jürgen$$b14$$udkfz 000306185 7001_ $$aEl Shafie, Rami A$$b15 000306185 773__ $$0PERI:(DE-600)1500707-8$$a10.1016/j.radonc.2025.111279$$gp. 111279 -$$p111279$$tRadiotherapy and oncology$$v214$$x0167-8140$$y2026 000306185 909CO $$ooai:inrepo02.dkfz.de:306185$$pVDB 000306185 9101_ $$0I:(DE-588b)2036810-0$$6P:(DE-He78)8714da4e45acfa36ce87c291443a9218$$aDeutsches Krebsforschungszentrum$$b14$$kDKFZ 000306185 9131_ $$0G:(DE-HGF)POF4-315$$1G:(DE-HGF)POF4-310$$2G:(DE-HGF)POF4-300$$3G:(DE-HGF)POF4$$4G:(DE-HGF)POF$$aDE-HGF$$bGesundheit$$lKrebsforschung$$vBildgebung und Radioonkologie$$x0 000306185 9141_ $$y2025 000306185 915__ $$0StatID:(DE-HGF)0420$$2StatID$$aNationallizenz$$d2025-01-07$$wger 000306185 915__ $$0StatID:(DE-HGF)0200$$2StatID$$aDBCoverage$$bSCOPUS$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)0300$$2StatID$$aDBCoverage$$bMedline$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)0199$$2StatID$$aDBCoverage$$bClarivate Analytics Master Journal List$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)1050$$2StatID$$aDBCoverage$$bBIOSIS Previews$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)0160$$2StatID$$aDBCoverage$$bEssential Science Indicators$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)1190$$2StatID$$aDBCoverage$$bBiological Abstracts$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)1110$$2StatID$$aDBCoverage$$bCurrent Contents - Clinical Medicine$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)0113$$2StatID$$aWoS$$bScience Citation Index Expanded$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)0150$$2StatID$$aDBCoverage$$bWeb of Science Core Collection$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)0100$$2StatID$$aJCR$$bRADIOTHER ONCOL : 2022$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)0600$$2StatID$$aDBCoverage$$bEbsco Academic Search$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)0030$$2StatID$$aPeer Review$$bASC$$d2025-01-07 000306185 915__ $$0StatID:(DE-HGF)9905$$2StatID$$aIF >= 5$$bRADIOTHER ONCOL : 2022$$d2025-01-07 000306185 9201_ $$0I:(DE-He78)E050-20160331$$kE050$$lE050 KKE Strahlentherapie$$x0 000306185 9201_ $$0I:(DE-He78)HD01-20160331$$kHD01$$lDKTK HD zentral$$x1 000306185 980__ $$ajournal 000306185 980__ $$aVDB 000306185 980__ $$aI:(DE-He78)E050-20160331 000306185 980__ $$aI:(DE-He78)HD01-20160331 000306185 980__ $$aUNRESTRICTED