Clinical outcomes of Satir model combined with seamless continuous nursing in conjunction with Gamma Knife for brain metastases

Gamma Knife radiosurgery achieves high local control rates in brain metastases, yet its long-term efficacy is often undermined by emotional distress, delayed symptom recognition, and poor medication adherence, factors that may disrupt immune modulation, reduce radiosensitivity, and increase toxicity. This prospective, randomised trial evaluated whether integrating Satir-model psychological intervention and seamless continuous nursing into the Gamma Knife workflow could enhance radiation outcomes. A total of 120 patients were randomised to receive either standard Gamma Knife treatment with routine care or an augmented protocol incorporating structured psychotherapeutic guidance and a closed-loop nursing system. Dosimetric parameters were equivalent between groups. The intervention group showed significantly lower 90-day fatigue incidence (P = 0.043), a higher 12-month disease control rate (63.33 % vs. 36.67 %, P = 0.006), and prolonged intracranial progression-free survival (iPFS) (HR = 0.65, P = 0.045). Improvements were also observed in Karnofsky Performance Status (KPS), anxiety and depression scores, quality of life, heart rate variability, and medication adherence. Multivariate analysis identified the combined intervention as a protective factor for iPFS that is independent of other factors. These findings suggest that structured psycho-nursing integration can enhance the therapeutic impact of precision radiosurgery without altering the physical dose, providing a scalable strategy to improve clinical efficacy and functional recovery in the management of brain metastases.