Irradiated Volume as a Predictor of Brain Radionecrosis After Linear Accelerator Stereotactic Radiosurgery

Analysis of patient and treatment variables revealed V8 Gy-V16 Gy to be the best predictors for RN using linear accelerator-based single-fraction SRS for brain metastases. We propose that patients with V10 Gy >10.5 cm3 or V12 Gy >7.9 cm3 be considered for hypofractionated rather than single-fraction treatment, to minimize the risk of symptomatic RN.