{"entity":{"id":"paper-n107c-brown-lancet-oncol-2017","kind":"paper","name":"N107C/CEC.3: postoperative radiosurgery versus whole-brain radiotherapy after resection of a brain metastasis","aka":[],"tldr":"After surgery to remove a brain metastasis, focused radiosurgery to the cavity preserved thinking and memory far better than whole-brain radiotherapy and gave the same survival, so it became the standard.","summary":"Phase 3 trial of 194 patients with one resected brain metastasis (and up to three unresected) randomised to stereotactic radiosurgery to the surgical cavity or whole-brain radiotherapy.\n\nCognitive deterioration-free survival was 3.7 versus 3.0 months (hazard ratio 0.47) and cognitive decline at six months was 52 versus 85 percent; overall survival was similar (12.2 versus 11.6 months) although whole-brain radiotherapy gave better intracranial control.","asOf":"2026-09-17","links":[{"label":"Lancet Oncol 2017","url":"https://doi.org/10.1016/S1470-2045(17)30441-2"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28687377/"}],"tags":[],"related":[],"cancers":["secondary-brain-tumours"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-oncology"],"dependsOn":[],"notes":[],"journal":"The Lancet Oncology","year":2017,"doi":"10.1016/S1470-2045(17)30441-2","pmid":"28687377","authors":"Brown PD, Ballman KV, Cerhan JH, et al.","paperType":"rct","findings":["Cognitive deterioration at six months 52 percent vs 85 percent.","Median overall survival 12.2 vs 11.6 months (no difference)."],"whatItMeans":"Surgical cavity radiosurgery, rather than whole-brain radiotherapy, follows resection of a brain metastasis in fit patients, part of the broader move away from whole-brain treatment.","caveats":["Surgical bed control was lower with radiosurgery than with whole-brain radiotherapy (about 61 vs 81 percent at one year).","Leptomeningeal relapse is a concern after cavity radiosurgery."],"changedPractice":true,"participants":194},"route":"/key-papers/paper-n107c-brown-lancet-oncol-2017/","neighbours":{"cancer":[{"id":"secondary-brain-tumours","kind":"cancer","name":"Brain metastases (secondary brain tumours)","route":"/cancers/secondary-brain-tumours/"}],"journal":[{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","route":"/journals/lancet-oncology/"}]}}