A multicenter clinical trial led by researchers at The University of Texas MD Anderson Cancer Center found that implanting collagen tiles during brain surgery to deliver targeted radiation therapy improved tumor control, lowered the risk of recurrence, and increased overall survival compared to standard care for patients with newly diagnosed brain metastases who require surgical resection, according to a May 30 announcement.
The ROADS trial was co-led by Jeffrey Weinberg, M.D., professor of Neurosurgery, and Thomas Beckham, M.D., Ph.D., assistant professor of CNS Radiation Oncology. It is the first randomized controlled Phase 3 trial comparing cesium-131 collagen tile-based radiation therapy (TBRT) against standard postoperative stereotactic radiation therapy (SRT). Weinberg presented the results at the 2026 American Society of Clinical Oncology Annual Meeting.
After one year, patients treated with TBRT had a 1.3% rate of recurrence at the surgical site compared to 15.4% for those in the SRT group. Median overall survival was reported as 42.5 months with TBRT—more than double the 17.6 months seen with standard SRT.
TBRT uses a Food and Drug Administration-cleared low-dose brachytherapy device developed by GT Medical Technologies, Inc. The small tiles contain evenly spaced seeds filled with cesium-131 embedded in a collagen matrix that is applied to the cavity left after surgery. This method ensures even distribution of radiation across areas where microscopic tumor cells may remain while limiting exposure to healthy tissue.
There were no differences in serious treatment-related side effects between TBRT and SRT groups; rates of radiation necrosis were nearly identical as well. Most patients receiving TBRT completed cranial radiation in just one day, compared with a median of 32 days for those undergoing postoperative SRT.
“These results are dramatically better than the current alternatives and provide improved patient convenience by getting them over the roadblock of a brain metastasis diagnosis more quickly,” Beckham said. He added that returning patients sooner to systemic cancer treatments could positively impact outcomes beyond surgery alone.
The researchers said they hope these findings will accelerate guideline adoption for TBRT and support broader clinical rollout.
