Current status and optimal use of radiosurgery

Area of Science:

• Neurosurgery
• Radiation Oncology
• Medical Physics

Background:

• Stereotactic radiosurgery (SRS) is rapidly evolving due to technological advancements and enhanced clinical understanding.
• Key areas of development include brain metastases, arteriovenous malformations, and nasopharyngeal carcinoma treatment.

Purpose of the Study:

• To review recent advancements in stereotactic radiosurgery.
• To highlight innovations in equipment and clinical applications.
• To discuss the expanding scope of radiosurgery for various intracranial and extracranial lesions.

Main Methods:

• Review of recent developments in radiosurgical equipment and clinical applications.
• Discussion of specific treatment areas: brain metastases, arteriovenous malformations, nasopharyngeal carcinoma, acoustic neuromas, and tumors near visual pathways.
• Focus on the impact of frameless, image-guided SRS and nonisocentric treatment algorithms.

Main Results:

• Improved understanding of SRS for brain metastases and arteriovenous malformations.
• Successful application of SRS as a boost for nasopharyngeal carcinoma to reduce local recurrence.
• Fractionated SRS is now used for acoustic neuromas and tumors near visual pathways due to better radiobiology understanding.
• Frameless, image-guided SRS enables dose homogeneity, improved target conformality, and treatment of extracranial lesions.

Conclusions:

• Recent advancements in stereotactic radiosurgery equipment and understanding have significantly improved treatment efficacy.
• Frameless, image-guided SRS represents a major breakthrough, enhancing precision and expanding treatment possibilities for a wider range of lesions.
• The field continues to evolve, offering more precise and effective therapeutic options for complex neurological conditions.