Scholars@Duke
Eugene John Vaios

Eugene John Vaios

Assistant Professor of Radiation Oncology
Radiation Oncology
eugene.vaios@duke.edu
30 Duke Medicne Cir, Box 3085, Durham, NC 27710

Selected Publications

Identifying Predictive Factors for Radiation Necrosis vs. Local Recurrence in Biopsy-Proven Enlarging Lesions Post-Stereotactic Radiosurgery for Brain Metastases

Journal Article Neuro-Oncology Practice · December 10, 2025 Lay SummaryCancers that spread to the brain are often treated with focused radiation. After treatment, brain scans sometimes show that the treated area continues to grow, which can mean radiation-related ... Full text Cite

Neurocognitive outcomes in patients with brain metastases: a systematic review.

Journal Article Lancet Oncol · December 2025 Multimodality therapy, including surgery, radiotherapy, and systemic therapy, has significantly improved overall survival for patients with brain metastases. However, treatment-related neurocognitive sequelae remain a major challenge in survivorship. Altho ... Full text Link to item Cite

Management outcomes for biopsy-proven radiation necrosis in patients with brain metastases in the era of immune-checkpoint blockade.

Journal Article J Neurooncol · October 2025 PURPOSE: Immunotherapy and stereotactic radiosurgery (SRS) are frequently combined in the management of brain metastases from non-small cell lung cancer (NSCLC) and melanoma. However, concurrent SRS and dual immune-checkpoint inhibition (ICPI) elevate the ... Full text Open Access Link to item Cite

Seizure risk factors and management approaches in patients with brain metastases.

Journal Article Neurooncol Pract · June 2025 A significant proportion of patients with brain metastases experience a seizure event during their disease course, which can impact morbidity and long-term outcomes. A host of factors elevate the risk for seizures in patients with brain metastases, includi ... Full text Link to item Cite

Total brain dose estimation in single-isocenter-multiple-targets (SIMT) radiosurgery via a novel deep neural network with spherical convolutions.

Journal Article Med Phys · June 2025 BACKGROUND AND PURPOSE: Accurate prediction of normal brain dosimetric parameters is crucial for the quality control of single-isocenter multi-target (SIMT) stereotactic radiosurgery (SRS) treatment planning. Reliable dose estimation of normal brain tissue ... Full text Link to item Cite

Improved Survival and Prognostication in Melanoma Patients With Brain Metastases: An Update of the Melanoma Graded Prognostic Assessment.

Journal Article J Clin Oncol · June 2025 PURPOSE: Survival for patients with melanoma has recently improved. The propensity of melanoma to metastasize to the brain remains a common and serious feature of this disease. The purposes of this study were to evaluate prognostic factors for patients wit ... Full text Link to item Cite

Radiogenomic explainable AI with neural ordinary differential equation for identifying post‐SRS brain metastasis radionecrosis

Journal Article Medical Physics · April 2025 AbstractBackgroundStereotactic radiosurgery (SRS) is widely used for managing brain metastases (BMs), but an adverse effect, radionecrosis, complicates post‐SRS management. Differentiating ... Full text Cite

Unique brain injury patterns after proton vs photon radiotherapy for WHO grade 2-3 gliomas

Journal Article The Oncologist · December 6, 2024 AbstractBackgroundCentral nervous system (CNS) injury following brain-directed radiotherapy remains a major challenge. Proton radiothe ... Full text Cite

Dose-Incorporated Deep Ensemble Learning for Improving Brain Metastasis Stereotactic Radiosurgery Outcome Prediction.

Journal Article Int J Radiat Oncol Biol Phys · October 1, 2024 PURPOSE: To develop a novel deep ensemble learning model for accurate prediction of brain metastasis (BM) local control outcomes after stereotactic radiosurgery (SRS). METHODS AND MATERIALS: A total of 114 brain metastases (BMs) from 82 patients were evalu ... Full text Link to item Cite

Long-Term Intracranial Outcomes With Combination Dual Immune-Checkpoint Blockade and Stereotactic Radiosurgery in Patients With Melanoma and Non-Small Cell Lung Cancer Brain Metastases.

Journal Article Int J Radiat Oncol Biol Phys · April 1, 2024 PURPOSE: The intracranial benefit of offering dual immune-checkpoint inhibition (D-ICPI) with ipilimumab and nivolumab to patients with melanoma or non-small cell lung cancer (NSCLC) receiving stereotactic radiosurgery (SRS) for brain metastases (BMs) is u ... Full text Link to item Cite

Quantifying U-Net uncertainty in multi-parametric MRI-based glioma segmentation by spherical image projection.

Journal Article Med Phys · March 2024 BACKGROUND: Uncertainty quantification in deep learning is an important research topic. For medical image segmentation, the uncertainty measurements are usually reported as the likelihood that each pixel belongs to the predicted segmentation region. In pot ... Full text Link to item Cite

Effects of Ataxia-Telangiectasia Mutated Variants on Radionecrosis and Local Control After Stereotactic Radiation Surgery for Non-Small Cell Lung Cancer Brain Metastases.

Journal Article Adv Radiat Oncol · January 2024 PURPOSE: Genetic variants affecting the radiation response protein ataxia-telangiectasia mutated (ATM) have been associated with increased adverse effects of radiation but also with improved local control after conventional radiation therapy. However, it i ... Full text Link to item Cite

Impact of TP53 mutations on brain metastasis control in non-small cell lung cancer patients undergoing stereotactic radiosurgery.

Journal Article J Radiosurg SBRT · 2024 PURPOSE: To investigate whether TP53 variants may be correlated with overall survival and local control following stereotactic radiosurgery (SRS) for brain metastases (BMs) from non-small cell lung cancer (NSCLC). METHODS: Patients undergoing an initial co ... Link to item Cite

Mitigating Radiotoxicity in the Central Nervous System: Role of Proton Therapy

Journal Article Current Treatment Options in Oncology · November 2023 Full text Cite

A neural ordinary differential equation model for visualizing deep neural network behaviors in multi-parametric MRI-based glioma segmentation.

Journal Article Med Phys · August 2023 PURPOSE: To develop a neural ordinary differential equation (ODE) model for visualizing deep neural network behavior during multi-parametric MRI-based glioma segmentation as a method to enhance deep learning explainability. METHODS: By hypothesizing that d ... Full text Link to item Cite

Risk of Tract Seeding Following Laser Interstitial Thermal Therapy for Brain Tumors.

Journal Article Neurosurgery · July 1, 2023 BACKGROUND: The management of intracranial oncological disease remains a significant challenge despite advances in systemic cancer therapy. Laser interstitial thermal therapy (LITT) represents a novel treatment for local control of brain tumors through pho ... Full text Link to item Cite

Novel Mechanisms and Future Opportunities for the Management of Radiation Necrosis in Patients Treated for Brain Metastases in the Era of Immunotherapy.

Journal Article Cancers (Basel) · April 24, 2023 Radiation necrosis, also known as treatment-induced necrosis, has emerged as an important adverse effect following stereotactic radiotherapy (SRS) for brain metastases. The improved survival of patients with brain metastases and increased use of combined s ... Full text Link to item Cite

Long-term outcomes with reduced-dose whole-brain radiotherapy and a stereotactic radiosurgery boost for primary central nervous system lymphoma.

Journal Article Neurooncol Adv · 2023 BACKGROUND: Primary central nervous system lymphoma (PCNSL) is an aggressive diffuse large B-cell lymphoma. Treatment approaches are historically associated with neurotoxicity, particularly with high-dose whole-brain radiotherapy (WBRT). We hypothesized th ... Full text Link to item Cite

Handbook of Neuro-Oncology Neuroimaging

Book · August 25, 2022 With treatment approaches and the field of neuro-oncology neuroimaging changing rapidly, this third edition of the Handbook of Neuro-Oncology Neuroimaging is very relevant to those in the field, providing a single-source, comprehensive, ... ... Cite

Factors Associated With New-Onset Seizures Following Stereotactic Radiosurgery for Newly Diagnosed Brain Metastases.

Journal Article Adv Radiat Oncol · 2022 PURPOSE: Stereotactic radiosurgery (SRS) is a highly effective therapy for newly diagnosed brain metastases. Prophylactic antiepileptic drugs are no longer routinely used in current SRS practice, owing to a perceived low overall frequency of new-onset seiz ... Full text Link to item Cite

Resolution of radiation necrosis with bevacizumab following radiation therapy for primary CNS lymphoma.

Journal Article Oncotarget · 2022 IMPORTANCE: Radiation necrosis (RN) is a rare but serious adverse effect following treatment with radiation therapy. No standard of care exists for the management of RN, and efforts to prevent and treat RN are limited by a lack of insight into the pathomec ... Full text Link to item Cite

Combination laser interstitial thermal therapy plus stereotactic radiotherapy increases time to progression for biopsy-proven recurrent brain metastases.

Journal Article Neurooncol Adv · 2022 BACKGROUND: Improved survival for patients with brain metastases has been accompanied by a rise in tumor recurrence after stereotactic radiotherapy (SRT). Laser interstitial thermal therapy (LITT) has emerged as an effective treatment for SRT failures as a ... Full text Link to item Cite

Central nervous system injury from novel cancer immunotherapies

Journal Article Current Opinion in Neurology · December 2020 Purpose of reviewNeurotoxicity from antineoplastic treatment remains a challenge in oncology. Cancer treatment-induced central nervous system (CNS) injury can be therapy-limiting, severel ... Full text Cite

Defining Treatment-Related Adverse Effects in Patients with Glioma: Distinctive Features of Pseudoprogression and Treatment-Induced Necrosis

Journal Article The Oncologist · August 1, 2020 AbstractBackgroundPseudoprogression (PP) and treatment-induced brain tissue necrosis (TN) are challenging cancer treatment–related eff ... Full text Cite

Proton beam radiotherapy for anal and rectal cancers

Journal Article Journal of Gastrointestinal Oncology · February 2020 Full text Cite

Eosinophil and lymphocyte counts predict bevacizumab response and survival in recurrent glioblastoma

Journal Article Neuro-Oncology Advances · January 1, 2020 AbstractBackgroundThere is a lack of biomarkers to identify glioblastoma (GBM) patients who may benefit from specific salvage therapie ... Full text Cite

Bone marrow response as a potential biomarker of outcomes in glioblastoma patients

Journal Article Journal of Neurosurgery · July 2017 OBJECTIVEGlioblastoma (GBM) is a highly aggressive malignancy that requires a multidisciplinary therapeutic approach of surgery, chemotherapy, and radiation therapy, but therapy is frequently limited by side effec ... Full text Cite

Target-Derived Neurotrophins Coordinate Transcription and Transport of Bclw to Prevent Axonal Degeneration

Journal Article The Journal of Neuroscience · March 20, 2013 Establishment of neuronal circuitry depends on both formation and refinement of neural connections. During this process, target-derived neurotrophins regulate both transcription and translation to enable selective axon survival or elimination. Howe ... Full text Cite