A large clinical trial has found that tile-based radiation therapy dramatically reduces the return of brain metastases after surgery, with results published in the Journal of Clinical Oncology.

The ROADS phase 3 trial, led by MD Anderson Cancer Center, compared GammaTile, an implant placed during surgery, with standard external beam radiation.

After one year, tumours returned at treated sites in only 1.3 per cent of patients who received GammaTile, compared with 15.4 per cent of those given standard therapy.

Median overall survival was 42.5 months with GammaTile versus 17.6 months with the conventional approach, a striking difference for patients with brain metastases.

The researchers said the treatment should be considered a new standard-of-care option for newly diagnosed operable brain metastases. Brain metastases affect a significant share of cancer patients, and recurrence after surgery has long been a major challenge. Placing radiation directly at the tumour site avoids delays and spares healthy tissue. Experts not involved in the study said the findings could change practice, though wider adoption will depend on surgical access and cost.