[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-461472-105":59,"doc-detail-461472-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","the-role-of-biological-effective-dose-in-gamma-knife-radiosurgery-a-systematic-review-across-multiple-indications","The Role of Biological Effective Dose in Gamma Knife Radiosurgery - A Systematic Review Across Multiple Indications","","Gamma Knife radiosurgery (GKS) is widely used for intracranial disorders, and biological effective dose (BED) is increasingly considered in treatment planning. This qualitative systematic review evaluates how BED models are applied across multiple indications—including pituitary adenomas, vestibular schwannomas, meningiomas, arteriovenous malformations (AVMs), trigeminal neuralgia, and other conditions—and compares BED with outcomes and adverse effects. Evidence shows the BED–outcome relationship is most consistent in AVMs, while other indications remain variable. BED-derived parameters may improve prediction of hypopituitarism and AVM obliteration, but most data are retrospective. Prospective validation is required.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-role-of-biological-effective-dose-in-gamma-knife-radiosurgery-a-systematic-review-across-multiple-indications/461472/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-role-of-biological-effective-dose-in-gamma-knife-radiosurgery-a-systematic-review-across-multiple-indications/461472.png","ImageObject",300,407,{"name":92,"@type":93},"Rainbow Cat","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the purpose of incorporating biological effective dose (BED) into Gamma Knife radiosurgery (GKS) planning?","Question",{"text":112,"@type":113},"The review assesses whether BED can improve prediction of treatment efficacy and toxicity compared with conventional physical dose metrics across multiple intracranial indications.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which indication shows the most consistent relationship between BED and clinical outcomes?",{"text":117,"@type":113},"AVMs show the most consistent findings, where higher BED correlates closely with obliteration rates.",{"name":119,"@type":110,"acceptedAnswer":120},"What limitation in the current evidence base is highlighted by the review?",{"text":121,"@type":113},"Most available evidence is derived from retrospective studies, and prospective studies are needed to confirm routine clinical utility.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},461472,1791053879,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962090769181,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Systematic Review  \nThe Role of Biological Effective Dose in Gamma Knife  \nRadiosurgery: A Systematic Review Across Multiple Indications  \nHao Deng 1,†, Xinyuejia Huang 1,†, Qian Wang 2, Yuan Gao 1, Mengqi Wang 1, Yang Wu 1, Xiaoman Shi 1, Maoyu Wang 1, Wei Pan 1, Senlin Yin 1,* and Wei Wang 1, *  \nAcademic Editors: Thomas Vogl and Emmanuel Andrès  \nReceived: 13 November 2025  \nRevised: 6 December 2025  \nAccepted: 31 December 2025  \nPublished: 5 January 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Neurosurgery, West China Hospital of Sichuan University, 37 Guoxue Alley, Chengdu 610041, China; [2023324025260@stu.scu.edu.cn](2023324025260@stu.scu.edu.cn) (H.D.); [hxyj2023@stu.scu.edu.cn](hxyj2023@stu.scu.edu.cn) (X.H.); [gaoyuan_scu@wchscu.cn](gaoyuan_scu@wchscu.cn) (Y.G.); [wmq_1101@scu.edu.cn](wmq_1101@scu.edu.cn) (M.W.); [2023224025415@stu.scu.edu.cn](2023224025415@stu.scu.edu.cn) (X.S.); [18011376726@163.com](18011376726@163.com) (W.P.)  \n2 Department of Respiratory and Critical Care Medicine, West China Hospital, Chengdu 610041, China; [wq1996wcrm@foxmail.com](wq1996wcrm@foxmail.com)  \n* Correspondence: [senlinyin@scu.edu.cn](senlinyin@scu.edu.cn) (S.Y.); [wcnsww@163.com](wcnsww@163.com) (W.W.)† These authors contributed equally to this work.  \nAbstract  \nBackground: Gamma Knife radiosurgery (GKS) is widely used for the management of intracranial disorders. Emerging evidence suggests that incorporating the biological effective dose (BED) into GKS planning may improve the prediction of treatment efficacy and toxicity. This review aims to evaluate the role of BED in GKS across multiple intracranial indications. Methods: A qualitative review of published clinical studies was performed to assess the application of BED models in GKS for pituitary adenomas, vestibular schwannomas, meningiomas, arteriovenous malformations (AVMs), trigeminal neuralgia, and other disorders. The relationships between BED, treatment outcomes, and adverse effects were compared across indications. Results: The association between BED and clinical outcomes was most consistent in AVMs, where higher BED correlated closely with obliteration rates. In other diseases, BED-based analyses showed promising but variable predictive value. Notably, BED-derived parameters demonstrated improved prediction of post-GKS hypopituitarism in pituitary adenomas and AVM obliteration compared with physical dose alone. However, most available evidence was derived from retrospective studies. Conclusions: BED may serve as a valuable complement to conventional physical dose metrics in GKS planning, but its ability to replace physical dose remains uncertain. Prospective studies and histology-specific radiobiological parameter validation are required to establish the routine clinical utility of BED.  \nKeywords: Gamma knife radiosurgery; biological effective dose; intracranial tumor; arteriovenous malformation; trigeminal neuralgia; essential tremor  \n1. Introduction  \nGamma knife radiosurgery (GKS) is a widely used radiotherapy technique for treating intracranial disorders. It is now indicated for a large variety of diseases, including pituitary tumors, vestibular schwannomas, arteriovenous malformations (AVMs), meningiomas, metastases, and functional disorders [1–5] . GKS delivers a single, high-dose radiation treatment with submillimeter precision, which minimizes damage to adjacent healthy tissue [1] . Although previous studies have identified the recommended range of physical doses for various indications, determining the optimal radiation dose to maximize treatment efficacy while minimizing adverse effects remains a significant challenge.  \nIncreasing evidence suggests that incorporating the biological effective dose (BED) into GKS treatment plans may enhance outcomes [6,7] . The concept of BED, ","cbCaimJuMSvAzBs3","https://ap.wps.com/l/cbCaimJuMSvAzBs3","pdf",561943,13,"English","# Introduction\n# Methods","[{\"question\":\"What is the purpose of incorporating biological effective dose (BED) into Gamma Knife radiosurgery (GKS) planning?\",\"answer\":\"The review assesses whether BED can improve prediction of treatment efficacy and toxicity compared with conventional physical dose metrics across multiple intracranial indications.\"},{\"question\":\"Which indication shows the most consistent relationship between BED and clinical outcomes?\",\"answer\":\"AVMs show the most consistent findings, where higher BED correlates closely with obliteration rates.\"},{\"question\":\"What limitation in the current evidence base is highlighted by the review?\",\"answer\":\"Most available evidence is derived from retrospective studies, and prospective studies are needed to confirm routine clinical utility.\"}]","The Role of Biological Effective Dose in Gamma Knife Radiosurgery - A Systematic Review Across Multiple Indications | PDF",1790761688,33]