Impact of stereotactic radiosurgery dose on local control and radiation necrosis in metastatic brain lesions: a comparative study.

127 lesions were treated with 20 Gy (38.3%), 183 with 22 Gy (55.1%), and 22 with 24 Gy (6.6%).

On multivariable logistic regression, 22 Gy was still associated with higher odds of 1-year local control compared with 20 Gy (adjusted OR 3.04, 95% CI 1.22-7.59; p = 0.017).

Both stereotactic radiosurgery dose and gross tumor volume were independent predictors of radiation necrosis (dose adjusted OR 2.05, p = 0.016; gross tumor volume adjusted OR 1.40 per doubling volume, p < 0.001).

Overall survival did not differ significantly by dose (p = 0.63).