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News
A phase 3 trial shows that implanting cesium-131 tiles during brain tumor surgery dramatically reduces recurrence compared to standard post-op radiation. Patients who received tile-based therapy saw a 12-month recurrence rate of just 1.3% vs. 15.4% with standard care. Overall survival was also notably longer — 42.5 months vs. 17.6 months.
A landmark phase 3 randomized controlled trial has found that cesium-131 tile-based radiation therapy (TBRT), implanted directly during surgical resection of brain metastases, significantly outperforms standard postoperative stereotactic radiation therapy (SRT) — and without added toxicity. The trial, led by researchers at MD Anderson Cancer Center and published in the Journal of Clinical Oncology, enrolled 230 patients across 32 U.S. centers between April 2021 and August 2025.
Patients receiving TBRT during surgery showed dramatically better local tumor control and survival outcomes. Median time to surgical bed recurrence was not reached in the TBRT group, compared to 17.4 months with SRT. Importantly, these gains came with no increase in radiation necrosis, neurocognitive decline, or quality-of-life deterioration.
By the Numbers:
Why it matters: Brain metastases are among the most challenging oncologic complications to manage. This trial offers compelling evidence that intraoperative radiation with cesium-131 tiles could redefine the standard of care, delivering superior local control and survival without compromising patient safety or quality of life.
