Tile therapy halves metastasis recurrence, extends survival

A new method of delivering radiation directly to the brain during surgery has been shown to dramatically improve outcomes for patients with brain metastases, according to results from a major clinical trial. The findings, presented at the 2026 American Society of Clinical Oncology Annual Meeting, indicate the approach could redefine the standard of care for patients requiring surgical removal of a brain tumor.

The multicenter Phase 3 trial, known as ROADS, compared a novel tile-based radiation therapy (TBRT) against the current standard treatment, which is stereotactic radiation therapy (SRT) administered weeks after surgery. The trial involved 204 patients with newly diagnosed brain metastases who underwent surgical resection at 32 U.S. centers.

In the new approach, surgeons line the cavity left after tumor removal with small, postage stamp-sized collagen tiles embedded with radioactive cesium-131 seeds. This "wallpapers" the surgical site with a source of low-dose radiation that acts over several weeks, targeting microscopic cancer cells immediately. The current standard involves patients returning for external beam radiation after they have recovered from surgery, a process...