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Radiation Necrosis after Radiation Therapy Treatment of Brain Metastases: A Computational Approach

Beatriz Ocaña-Tienda, Odelaisy León-Triana, Julián Pérez-Beteta, Juan Jiménez-Sánchez, Víctor M. Pérez-García.


Metastasis is the process through which cancer cells break away from a primary tumor, travel through the blood or lymph system, and form new tumors in distant tissues. One of the preferred sites for metastatic dissemination is the brain, affecting more than 20% of all cancer patients. This figure is increasing steadily due to improvements in treatments of primary tumors. Stereotactic radiosurgery (SRS) is one of the main treatment options for patients with a small or moderate number of brain metastases (BMs).


Brain metastases (BM) are the most common intracranial malignancies in adults, with around 25% of patients with cancer developing brain metastases during the course of their diseases. Most BMs originate from primary cancers from lung, breast or from melanoma. Improvements in detection and primary tumor treatment leading to longer survival of cancer patients have resulted in an increase in the incidence of BMs in the last years.

Materials and Methods:

In the planning of radiation therapy and despite improvements in the accuracy of radiation therapy treatments, low doses of radiation are administered to the tissue surrounding the lesion to ensure that not only visible tumor cells but also those that are not visible in medical images are eliminated, to reduce the likelihood of tumor recurrence. However, this approach has the unavoidable consequence of damaging healthy tissues around the metastatic lesion.


Radiation necrosis is a common adverse effect associated with radiation treatment. To gain a deeper understanding of the growth dynamics of RN events, computational frameworks were developed, based on mathematical models of increasing complexity. These models provide mechanistic explanations for the observed growth dynamics of RN, and offer insight into the underlying mechanisms of this phenomenon.

Citation: Ocaña-Tienda B, León-Triana O, Pérez-Beteta J, Jiménez-Sánchez J, Pérez-García VM (2024) Radiation necrosis after radiation therapy treatment of brain metastases: A computational approach. PLoS Comput Biol 20(1): e1011400.

Editor: James Gallo, University at Buffalo - The State University of New York, UNITED STATES

Received: July 31, 2023; Accepted: January 21, 2024; Published: January 30, 2024.

Copyright: © 2024 Ocaña-Tienda et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The original code for the mesoscopic model has been made available in the repository

Funding: This research has been supported by the Spanish Ministerio de Ciencia e Innovación (grants PID2019-110895RB-100 and PDC2022-133520-I00), Junta de Comunidades de Castilla-La Mancha (grant SBPLY/21/180501/000145) to VMPG and BOT is supported by the Spanish Ministerio de Ciencia e Innovación (grant PRE2020-092178). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.


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