Clinical Outcomes of Stereotactic Radiotherapy for Brain Metastases: A Retrospective Single-Center Cohort Study from Morocco

Abstract

This study evaluates the clinical outcomes, treatment patterns, and safety of brain SRT for limited brain metastases (BM) in a Moroccan tertiary oncology center, addressing the scarcity of North African real-world data. We retrospectively analyzed patients with brain metastases treated with SRT (2022–2025), assessing survival outcomes using Kaplan–Meier analysis and toxicity according to CTCAE v5.0. A total of 70 patients were analyzed. The median age was 59 years (mean ± SD: 58 ± 10 years), and 54.3% (n = 38) were female. Lung (44.3%) and breast (38.6%) cancers were the most common primary malignancies. Most patients presented with oligometastatic intracranial disease (71.4% with a single lesion; mean: 1.6 lesions per patient). Prior neurosurgical resection was performed in 51.4% of cases. The median tumor size was 20 mm (range: 5–53 mm). The most frequently prescribed fractionation schedule was 27 Gy in 3 fractions (44.3%), followed by 30 Gy in 5 fractions (21.4%). The median interval between consultation and SRT initiation was 13 days (IQR: 10–20 days). The median follow-up duration was 18.6 months (IQR, 11.2–27.4 months). The median OS was 22 months, with 6-month and 12-month OS rates of 85.0% and 72.7%, respectively. The median iPFS was not reached, with 6-month and 12-month iPFS rates of 81.6% and 62.5%, respectively. Treatment was well tolerated, with no Grade ≥3 treatment-related toxicities or symptomatic radionecrosis reported. Brain SRT is a safe, effective, and feasible treatment for oligometastatic brain disease in Morocco, achieving outcomes comparable to international standards despite resource limitations.