PURPOSE: To evaluate dose selection and post-treatment management after Gamma Knife surgery (GKS) for large brain metastases, with a focus on early identification of true progression. METHODS: This retrospective single-institution study included 143 patients with large brain metastases (tumor volume ≥ 4 cm RESULTS: Median overall survival was 15.3 months. During follow-up, 47 lesions showed radiographic progression: 42 true progression, 4 pseudoprogression, and 1 intratumoral hemorrhage. The 6-, 12-, and 24-month cumulative incidences of true progression were 17.4%, 31.5%, and 33.1%, respectively. True progression did not differ by treatment modality or tumor volume. A marginal dose ≥ 57.6 Gy biologically effective dose (BED CONCLUSION: A BED CLINICAL TRIAL REGISTRATION: Clinical trial number: not applicable.
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A 1952 study studied this question.